What Is the Abortion Pill?

What is the abortion pill?

“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 misoprostol, call your nurse or doctor.

Your doctor or nurse may give you both medicines at the health center. In some states you can do a virtual visit and have the pills mailed to you or pick them up at a local pharmacy.

Your doctor or nurse will give you detailed directions about where, when, and how to take the medicines. And they’ll talk with you about medicines to manage side effects, like cramp pain and nausea.

How effective is the abortion pill?

The abortion pill is very effective. If you’re taking mifepristone and misoprostol, it depends on how far along the pregnancy is, and how many doses of medicine you take:

• At 8 weeks pregnant or less, it works about 94-98% of the time.
• At 8-9 weeks pregnant, it works about 94-96% of the time.
• At 9-10 weeks pregnant, it works about 91-93% of the time.
• If you take an extra dose of misoprostol, it works about 99% of the time.
• At 10-11 weeks pregnant, it works about 87% of the time.
• If you take an extra dose of misoprostol, it works about 98% of the time.

In general, taking both mifepristone and misoprostol works a bit better than taking misoprostol only.

Taking misoprostol alone works to end the pregnancy about 85-95% of the time — depending on how far along the pregnancy is and how you take the medicine.

The abortion pill usually works, but if it doesn’t, you can take more medicine or have a surgical abortion

When can I take the abortion pill?

In general, you can have a medication abortion up to 77 days (11 weeks) after the first day of your last period. If it’s been 78 days or more since the first day of your last period, you can have a surgical 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 on your own schedule, 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. And some people may not have an in-clinic abortion provider close by, so abortion pills are more available to them.

Your doctor, nurse, or health center staff can help you decide which kind of abortion is best for you.

Some women prefer the use of medicines to terminate a pregnancy because:

It may be used in early pregnancy.
It may be used at home.
It feels more natural, like a miscarriage.
It is less invasive than an in-clinic abortion.

Medicines can be used to end an early pregnancy. In many cases, the first day of your last period must be less than 9 weeks ago. If you are over 9 weeks pregnant, you may need to have a surgical abortion

Be very certain that you want to end your pregnancy. It is not safe to stop the medicines once you have started taking them. Doing so creates a very high risk for severe birth defects.

Who Should Not Have a Medical Abortion

You should not have a medicine abortion if you:

Are over 9 weeks pregnant (time since the start of your last period).
Have a blood clotting disorder or adrenal failure.
Have an IUD. It must be removed first.
Are allergic to the medicines that are used to end pregnancy.
Take any medicines that should not be used with a medical abortion.
Do not have access to a doctor or an emergency room.

Getting Ready for a Medical Abortion

The health care provider will:

Do a physical exam and ultrasound
Go over your medical history
Do blood and urine tests
Explain how the abortion medicines work
Have you sign consent forms

What Happens During a Medical Abortion

You may take the following medicines for the abortion:

Mifepristone - this is called the abortion pill or RU-486
Misoprostol
You will also take antibiotics to prevent infection

You will take mifepristone in the provider's office or clinic. This stops the hormone progesterone from working. The lining of the uterus breaks down so the pregnancy cannot continue.

The provider will tell you when and how to take the misoprostol. It will be about 6 to 72 hours after taking mifepristone. Misoprostol causes the uterus to contract and empty.

After taking the second medicine, you will feel a lot of pain and cramping. You will have heavy bleeding and see blood clots and tissue come out of your vagina. This most often takes 3 to 5 hours. The amount will be more than you have with your period. This means the medicines are working.

You may also have nausea, and you may vomit, have a fever, chills, diarrhea, and a headache.

You can take pain relievers such as ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) to help with the pain. Do not take aspirin. Expect to have light vaginal bleeding for up to 4 weeks after a medical abortion. You will need to have pads to wear. Plan to take it easy for a few weeks.

You should avoid vaginal intercourse for about a week after a medical abortion. You can get pregnant soon after an abortion, so talk with your provider about what birth control to use. Make sure you are using effective contraception before you resume sexual activity. You should get your regular period in about 4 to 8 weeks.

Follow up with Your Healthcare Provider

Make a follow-up appointment with your provider. You need to be checked to make sure the abortion was complete and that you are not having any problems. In case it did not work, you will need to have an in-clinic abortion.

Risks to Ending Pregnancy with Medicine

Most women have a medical abortion safely. There are a few risks, but most can be treated easily:
An incomplete abortion is when part of the pregnancy does not come out. You will need to have a surgical procedure to complete the abortion.
Heavy bleeding
Infection
Blood clots in your uterus

Medical abortions are typically very safe. In most cases, it does not affect your ability to have children unless you have a serious complication.

When to Call the Doctor

Serious problems must be treated right away for your safety. Go to nearest emergency if you have:

Heavy bleeding - you are soaking through 2 pads every hour for 2 hours
Blood clots for 2 hours or more, or if the clots are larger than a lemon
Signs that you are still pregnant

You should also call your doctor if you have signs of infection:

Bad pain in your stomach or back
A fever over 100.4°F (38°C) or any fever for 24 hours
Vomiting or diarrhea for more than 24 hours after taking the pills
Bad smelling vaginal discharge