How does the abortion pill work?

What do I need to do before I take the abortion pill?

Before you take the abortion pill, you’ll meet with your nurse, doctor, or health center staff to talk about whether abortion is the right decision for you, and what your abortion options are.

If you go to the health center in person, you may get an exam, lab tests, and an ultrasound to figure out how far into your pregnancy you are. In some states you can do a virtual visit, and if lab tests are needed you can do that at a local lab test provider.

Your nurse or doctor will let you know if there’s anything else you need to do to prepare for your abortion. They’ll give you written instructions on how to take your pills. You will have access to a caring professional through the process — you’ll get a number you can call 24/7 if you have any questions or concerns.

You’ll have a lot of bleeding and cramping after you take misoprostol, so plan ahead to make the process more comfortable. You can be at home, or wherever is comfortable for you to rest. You may also want to have someone you trust with you (or nearby) that you can call if you need anything. The abortion process takes several hours, so try to clear your schedule for the day and just focus on caring for yourself if you can.

Stock up on maxi pads, food, books, movies, or whatever you like to help pass the time, and a heating pad for cramps. Make sure you have some pain medicine like ibuprofen — but don’t take aspirin because it can make you bleed more.

What happens during a medication abortion?

The abortion pill process has several steps and usually includes 2 different medicines: mifepristone and misoprostol. You can also have an abortion using only misoprostol.

First, you take mifepristone. This pill stops the pregnancy from growing.  Most people don’t feel anything after taking the mifepristone.

The second medicine is misoprostol. You’ll either take the misoprostol right away, or up to 48 hours after you take the first pill — your doctor or nurse will let you know how and when to take it. This medicine causes cramping and bleeding that empties your uterus. The pregnancy tissue will come out through your vagina. The process is very similar to an early miscarriage.

You can take pain medicine like ibuprofen about 30 minutes before you take the misoprostol to help with cramps. Don’t take aspirin, because it can make you bleed more. You can also take anti-nausea medicine if your doctor or nurse gives it to you to help with side effects.

You can expect the cramping and bleeding to start 1-4 hours after taking the misoprostol. It’s normal to see large blood clots (up to the size of a lemon) or clumps of tissue during the abortion. But the pregnancy itself is very small — at 8 weeks, an embryo is about ¼ to ½ inch long. You may not see it when it comes out, especially if you’re less than 8 weeks pregnant.

The cramping and bleeding can last for several hours. Most people finish passing the pregnancy tissue in 4-5 hours, but it may take longer. The cramping and bleeding slows down after the pregnancy tissue comes out. You may have cramps on and off for 1 or 2 more days.

It’s normal to have some bleeding and spotting for several weeks after your abortion. You can use pads, tampons, or a menstrual cup —  whatever's the most comfortable for you. But your nurse or doctor may recommend you use pads while the abortion is happening so you can track how much you're bleeding.

The last step is to make sure the abortion worked. You may go back into the health center for an ultrasound or blood test. Or you’ll get a pregnancy test to take at home, followed by a phone call with your nurse or doctor if you want. These tests will make sure the abortion worked and that you’re healthy.

In the unlikely case that the abortion doesn't work and you're still pregnant, your doctor or nurse will discuss your options with you. You may need another dose of medicine or to have an in-clinic procedure to complete the abortion. If you have any questions or concerns during or after your abortion, Planned Parenthood can help you, even if we didn’t provide your abortion.

How does a medication abortion feel?

For most people, medication abortion feels like having an early miscarriage. You might have:

• lots of cramping and aches in your belly

• very heavy bleeding with large clots (If you don’t have any bleeding within 24 hours after using the second medicine, misoprostol, call your nurse or doctor.)

• an upset stomach and vomiting (Your doctor or nurse may give you medicine to help with nausea.)

• diarrhea

• dizziness

• tiredness

• mild fever (99-100° F) or chills on the day you take misoprostol. If you have a fever after the day you take the misoprostol pills, call your doctor or health center right away — it could be a sign that you’re getting an infection.

To help ease pain and make you more comfortable, you can:

• Take pain medication like ibuprofen (Advil or Motrin). Don’t take aspirin because it can make your bleeding worse.

• Take anti-nausea medicine.

• Put a heating pad or hot water bottle on your belly.

• Take a shower.

• Sit on the toilet.

• Have someone rub your back.