What is the abortion pill?
Medication abortion — also called the abortion pill — is a safe and effective way to end an early pregnancy.
How does the abortion pill work?
“Abortion pill” is the common name for using two different medicines to end a pregnancy: mifepristone and misoprostol.
First, you take a pill called mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone, stopping the pregnancy from growing.
Then you take the second medicine, misoprostol, either right away or up to 48 hours later. This medicine causes cramping and bleeding to empty your uterus. It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage. If you don’t have any bleeding within 24 hours after taking the second medicine, call your nurse or doctor.
Your doctor or nurse will give you both medicines at the health center. When and where you’ll take them depends on state laws and your health center’s policies. Your doctor or nurse will give you detailed directions about where, when, and how to take the medicines. You may also get some antibiotics to prevent infection.
How effective is the abortion pill?
The abortion pill is very effective. The effectiveness depends on how far along you are in your pregnancy when you take the medicine.
- For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times.
- For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times.
- For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times. If you’re given an extra dose of medicine, it works about 99 out of 100 times.
- For people who are 10-11 weeks pregnant, it works about 87 out of 100 times. If you’re given an extra dose of medicine, it works about 98 out of 100 times.
The abortion pill usually works, but if it doesn’t, you can take more medicine or have an in-clinic abortion to complete the abortion.
When can I take the abortion pill?
Depending on where you live, you may be able to get a medication abortion up to 77 days (11 weeks) after the first day of your last period. If it has been 78 days or more since the first day of your last period, you can have an in-clinic abortion to end your pregnancy.
Why do people choose the abortion pill?
Which kind of abortion you choose all depends on your personal preference and situation. With medication abortion, some people like that you don’t need to have a procedure in a doctor’s office. You can have your medication abortion at home or in another comfortable place that you choose. You get to decide who you want to be with during your abortion, or you can go it alone. Because medication abortion is similar to a miscarriage, many people feel like it’s more “natural” and less invasive.
Your doctor, nurse, or health center staff can help you decide which kind of abortion is best for you.
How does the abortion pill work?
The abortion pill causes cramping and bleeding that can last several hours or more. You can be at home, or wherever is comfortable for you. 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 you 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 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 the second medicine, 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 for support if you need anything.
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 — 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 includes two different medicines.
First, you take a pill called mifepristone. This medicine stops the pregnancy from growing. Some people feel nauseous or start bleeding after taking mifepristone, but it’s not common. Your doctor or nurse may also give you antibiotics to take to prevent infection.
The second medicine is called 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 to empty your 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 this is happening. It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage. (If you don’t have any bleeding within 24 hours after taking the second medicine, misoprostol, call your nurse or doctor.)
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 second medicine, 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 the first few days after the abortion so you can track how much you’re bleeding.
The last step is a follow up with your nurse or doctor. 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. 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 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 (If you don’t have any bleeding within 24 hours after taking 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.)
- 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.
How will I feel after taking the abortion pill?
How you feel during and after a medication abortion varies from person to person. On the day you take your second medicine, plan on resting and being in a comfortable place. You may feel tired for 1 or 2 days after, but you should be back to normal soon.
You can go back to work, school, driving, and most other normal activities the next day if you feel up to it. But DON’T do hard work or heavy exercise for several days. You should start to feel better as the days go by, but call your doctor or health center if you still feel ill.
After your abortion is complete, cramping and bleeding should lighten up as the hours and days go by. You may also have tender breasts, and they may leak a milky discharge. That should stop in a couple of days. Wearing a snug-fitting bra will help you feel more comfortable.
Any chills, fevers, or nausea you have should go away pretty quickly. Call your doctor or health center right away if you have nausea, vomiting, diarrhea, or a fever for more than 24 hours after taking misoprostol (the second set of pills). It could be a sign of an infection.
Your doctor or health care center staff will give you written after-care instructions, and a phone number you can call with any questions about abortion pill side effects or any other concerns. Follow all of your doctor’s directions during and after your abortion.
If you want, you can have a follow-up visit or phone call with your nurse or doctor to make sure that your abortion is complete and that you’re healthy.
People can have a range of emotions after having an abortion. Most people feel relief, but sometimes people feel sad or regretful. This is totally normal. If your mood keeps you from doing the things you usually do each day, call your doctor or nurse for help. You can also call Exhale or All-Options for free, confidential, and non-judgmental emotional support after an abortion — no matter how you’re feeling.
How will the abortion pill affect my periods?
It’s normal to bleed and spot off and on 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.
Abortion starts a new menstrual cycle, so your period should go back to normal 4-8 weeks after your abortion.
How soon can I have sex after a medication abortion?
You can have sex as soon as you feel ready.
When can I start using birth control after my medication abortion?
You can start a new birth control method immediately after having a medication abortion. You can get pregnant very quickly after your abortion, so it’s a good idea to talk with your nurse or doctor about birth control as soon as you can — they can help you find a method that’s right for you.
Can I breastfeed if I take the abortion pill?
The medicines in the abortion pill can sometimes pass into breastmilk. But it’s usually in small amounts that shouldn’t affect a baby. You can talk with your nurse or doctor if you’re breastfeeding, and they’ll help you figure out what’s best for you and your baby.
How safe is the abortion pill?
Medication abortion is very safe. Serious problems are rare, but like all medical procedures, there can be some risks.
What are the possible risks of taking the abortion pill?
Medication abortion has been used safely in the U.S. for more than 20 years. Serious complications are really rare, but can happen. These include:
- the abortion pills don’t work and the pregnancy doesn’t end
- some of the pregnancy tissue is left in your uterus
- blood clots in your uterus
- bleeding too much or too long
- allergic reaction to one of the medicines
These problems aren’t common. And if they do happen, they’re usually easy to take care of with medication or other treatments.
In extremely rare cases, some complications can be very serious or even life threatening. Call your doctor or health center right away if you:
- have no bleeding within 24 hours after taking the second medicine (misoprostol)
- have heavy bleeding from your vagina that soaks through more than 2 maxi pads in an hour, for 2 or more hours in a row
- pass large clots (bigger than a lemon) for more than 2 hours
- have belly pain or cramps that don’t get better with pain medication
- have a fever of 100.4 or higher more than 24 hours after taking misoprostol
- have weakness, nausea, vomiting, and/or diarrhea that lasts more than 24 hours after taking misoprostol
You should start to feel better the day after your abortion. Feeling sick with nausea, vomiting, diarrhea, belly pain, or a fever for more than 24 hours after taking misoprostol (the second set of pills) can be a sign of infection. Call your doctor or nurse right away if you have any of those symptoms. Serious problems can cause death in the most rare cases, but abortion is typically very safe. In fact, pregnancy and childbirth is riskier than most abortions.
If you have complications during your medication abortion, you may have to go back to the doctor’s office or health center. In the unlikely event that you are 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 abortion to end the pregnancy.
Like all medications, the abortion pill isn’t right for everyone. The abortion pill may not be right for you if you have certain medical conditions or take certain medications. Your doctor or nurse will talk with you and help you decide if the abortion pill is the right option for you.
Does the abortion pill have long-term side effects?
The abortion pill is really safe and effective. It’s a super common way to have an abortion, and millions of people have used it safely.
Unless there’s a rare and serious complication that’s not treated, there’s no risk to your future pregnancies or to your overall health. Having an abortion doesn’t increase your risk for breast cancer or affect your fertility. It doesn’t cause problems for future pregnancies like birth defects, premature birth or low birth weight, ectopic pregnancy, miscarriage, or infant death.
Serious, long-term emotional problems after an abortion are rare, and about as uncommon as they are after giving birth. They are more likely to happen in people who have to end a pregnancy because of health reasons, people who do not have support around their decision to have an abortion, or people who have a history of mental health problems. Most people feel relief after an abortion.
There are many myths out there about the effects of abortion. Your nurse or doctor can give you accurate information about abortion pill side effects or any other concerns you may have.