What is the abortion pill? The abortion pill is another name for mifepristone, one of the medicines that can be used to end an unwanted pregnancy. Studies show that the abortion pill works up to 63 days after the last period begins. The process of using the abortion pill is called medication abortion.
How does the abortion pill work? There are three steps. The first step, your clinician will give you a dose of mifepristone. The second step, you will return home and take another medication called misoprostol. The third step, you will return to your clinician for a follow-up visit.
Step One
Mifepristone — blocks the hormone progesterone. Without progesterone, the lining of the uterus breaks down, ending the pregnancy.
Step Two
Misoprostol — causes the uterus to contract and empty. This is the abortion.
Step Three
Follow-up. Your clinician needs to make sure the abortion is complete. You will need an ultrasound or blood test.
How long does it take? The process of the abortion begins immediately after taking the mifepristone. Some women may begin spotting before taking the misoprostol. For most, the bleeding and cramping associated with medication abortion begins after taking the misoprostol.
More than 50 percent of women who use mifepristone abort within four to five hours after taking misoprostol. Heavy bleeding may continue for about 13 days. Spotting can last for a few weeks.
It's important to remember that choosing the abortion pill instead of an in-clinic abortion, which is done with gentle suction in one visit, means that you will need to visit your clinician's office more than one time.
How effective is it? Medication abortion is about 97 percent effective. However, mifepristone and misoprostol can cause serious birth defects. If a medication abortion does not work, an in-clinic abortion must be done. In-clinic abortions end pregnancy by gently suctioning away the contents of the uterus.
During the first visit with your abortion provider, you will need to
discuss your options
sign a consent form
talk about your medical history
have laboratory tests
have a physical exam — including an ultrasound
You will also be given a medication guide to take home with you.
You will take the first medicine — mifepristone — in the clinic. You and your clinician will plan the next step according to what is best for you. You may take the second medicine — misoprostol — at home. Or you may need to return to the clinic.
After you take the misoprostol you will start to bleed heavily within hours or days. This is the abortion.
How does it feel? For most women, medication abortion is like an early miscarriage. You might
feel dizzy
feel strong cramps
feel nauseous or vomit
have diarrhea
feel temporary abdominal pain
have mild fever or chills
Acetaminophen — such as Tylenol or Excedrin — can reduce most of these symptoms. Painkillers such as ibuprofen — for example, Motrin or Advil — can also reduce symptoms. Do not take aspirin.
You may see large blood clots or tissue at the time of the abortion.
You may feel more at ease if you have a trusted loved one with you during the abortion.
You may have some bleeding for up to four weeks after. In general, your bleeding should get lighter and lighter. You may use pads or tampons during the abortion pill, but using pads makes it easier to keep track of your bleeding.
What are the risks of using the abortion pill? Rare, but possible, risks include
an allergic reaction to either of the pills
incomplete abortion — part of the pregnancy is left inside the uterus
infection
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
abdominal pain or discomfort that is not helped by medication, rest, a hot water bottle, or a heating pad
a fever of 100.4°F or higher that lasts for more than four hours
vomiting for more than four to six hours and you are not able to keep anything down
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.
Why do some women prefer the abortion pill?
There's no anesthesia.
It can be done early — women can begin treatment as soon as they know they are pregnant.
Women may feel more in control — many feel it is less invasive.
Women may feel it's more "natural" — many feel it is more like miscarriage.
There's more privacy — women may have the abortion at home.
Ninety-seven percent of women who have had the abortion pill would recommend the method to a friend.
Who can choose the abortion pill? You may choose the abortion pill if you
are up to 63 days pregnant
agree to have an in-clinic abortion if the abortion pill fails
have access to a telephone, transportation, and back-up medical care
are willing to have your IUD — if you have one — removed before taking the medicine
You should not use the abortion pill if you
are more than 63 days pregnant
are unwilling or unable to have an in-clinic abortion if the abortion pill is incomplete
cannot return for follow-up visits
have a known or suspected molar pregnancy — one in which the placenta develops cysts and the embryo either does not form at all or develops abnormally
have an allergy to the medications
have severe adrenal gland, heart, kidney, or liver problems
take any medicine that should not be combined with mifepristone, or misoprostol
take anti-clotting medication or have blood-clotting disorders
Will I need to prepare for the follow-up? Yes. After you take the medicine and before your follow-up exam
Do not take aspirin.
Do not take anti-coagulant (anti-clotting) drugs.
What if I'm still pregnant after taking the medicine? It is likely that you will need an in-clinic abortion.
How will I feel after a 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. 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 nonjudgmental support groups.
When will I get my period? Abortion begins a new menstrual cycle. You should have a regular period in four to eight weeks.
When can I have sex again? Don't have vaginal intercourse or insert anything except a tampon into the vagina for one week after the abortion. You can get pregnant very soon after the abortion. Discuss birth control options with your clinician.
Where can I get the abortion pill? Contact Planned Parenthood at 1-800-230-PLAN, other women's health care centers, or your private clinician. Planned Parenthood centers that do not provide the abortion pill can refer you to someone who does.
How much does it cost? The abortion pill involves two or three office visits, testing, and exams. Nationwide, the cost of the abortion pill ranges from $350 to $650. Costs may be more or less depending on locale and whatever additional tests, visits, or exams are needed. Costs vary from community to community, based on regional and local expenses. Contact your nearest Planned Parenthood health center 1-800-230-PLAN for information about costs in your area.
Sexuality and relationship info you can trust from Planned Parenthood® Federation of America
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