You’ll take pills and have your abortion at home. The abortion pill causes cramping and bleeding that can last several hours or more. Plan on taking it easy for the day.
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. You’ll get an exam and lab tests, and may get an ultrasound to figure out how far into your pregnancy you are.
Your nurse or doctor will let you know if there’s anything else you need to do 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 the second medicine at home. So plan ahead to make the process more comfortable. Choose a time when you’ll have some privacy and can rest for a while, and have someone you trust with you (or nearby) that you can call for support if you need anything.
Stock up on maxi pads, food, books or movies to help pass the time, and a heating pad for cramps. Make sure you have some pain medication — 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. It starts when you take the first pill.
First, you take a pill called mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone. Some people feel nauseous or start bleeding after taking mifepristone, but it’s not common. Your doctor or nurse will give you antibiotics to take to prevent infection.
Your doctor or nurse will also give you a medicine called misoprostol. You’ll use the misoprostol 6-48 hours after you take the first pill — your doctor or nurse will let you know how and when to do it. This medicine causes cramping and bleeding to empty the uterus.
For most people, the cramping and bleeding usually starts 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 when the abortion is happening. It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage.
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 cramping on and off for 1 or 2 more days.
You can take pain medicine like ibuprofen about 30 minutes before you take the misoprostol to help with cramps. You can also take anti-nausea medicine if your doctor or nurse gives it to you. Don’t take aspirin, because it can make you bleed more.
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 for a few days after the abortion so you can track how much you're bleeding.
The last step is a follow up visit. For the follow up, you’ll get an ultrasound or blood test. This will make sure your abortion is complete and you are well.
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 medication or to have an in-clinic procedure to complete the 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
an upset stomach and vomiting. (Your doctor or nurse may give you medicine to help with nausea.)
mild fever (99-100° F) or chills on the day you take the misoprostol. (If you have a fever after the day you take the misoprostol pills, call your doctor or health center right away.)
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.
Put a heating pad or hot water bottle on your belly.
Take a shower.
Sit on the toilet.
Have someone rub your back.