Medication Abortion

Medication abortion involves taking medications to cause a miscarriage. There are two ways to have a medication abortion: using mifepristone and misoprostol or using misoprostol alone.

Below is information about abortion publicly available for educational and informational purposes.

Medication Abortion involves taking two medications to induce a miscarriage. This method is FDA-approved for up to 10 weeks in pregnancy.

These medications are as follows:

Step 1: Mifepristone (200 mg) taken orally

Step 2: Misoprostol (800 mg) taken buccally 24-48 hours after taking
Mifepristone. Typically these are four (200 mg) tablets, 2 place on each side of
the cheeks).

  • These tablets are left to dissolve for 30 minutes before being swallowed.

  • If they do not completely dissolve- that is okay! As long as they have been sitting in your mouth for 30 minutes it is fine.

  • Alternate Medication Route: Misoprostol can be taken vaginally by placing the tablets into the vagina rather than into the cheeks. If you choose to manage your abortion this way, you can place the tablets into the vagina (all 800mcg at once) 0-48 hours after taking mifepristone. The failure rate increases slightly if misoprostol is taken less than 6 hours from taking mifepristone.

Bleeding typically starts within 1 to 4 hours of taking misoprostol, but it can taken up until 24 hours for the medication abortion to complete.

Image of one tablet of mifepristone and 4 tablets of misoprostol in a tiny medicine cup.

Below are common symptoms during a medication abortion:

  • Bleeding can vary from moderate to heavy and may include multiple clots of varying sizes.

  • Cramping varies from person to person and can be mild to severe.

    Talk with your healthcare provider about pain management options. If you don’t have a healthcare provider: over the counter pain medication like ibuprofen (600 or 800mg) can be helpful.

    Warm showers, back rubs, and heating pads (or anything that provides a safe level of warmth to the abdomen) can reduce cramping.

  • Nausea, vomiting, diarrhea are common and normal. These symptoms should improve 24 hours after taking misoprostol.

    Some people will experience a slight fever and/or chills.

Once misoprostol has been taken, take it easy for at least 24 hours. Take pain medication as recommended by your healthcare provider. You’ll want to have a phone on you in case of emergency and if you can stay within 1 hour of a hospital, that is ideal.

See below for Medication Guides from the makers of Mifepristone.

After a Medication Abortion

  • Bleeding can last for several weeks.

  • Cramping usually lasts for a week or so.

  • It can take 4-6 weeks to have your next period, though everyone’s body is different. You can ovulate very quickly after an abortion, meaning it is possible to get pregnant very quickly following an abortion.

Medication Abortion Risks:

  • It is possible to bleed too much during or after a medication abortion. This is uncommon, happening in less than 1 out of every 100 people (<1%) having a medication abortion.

    Monitor your bleeding and contact a health care provider immediately if you soak 2 or more pads in an hour for more than 2 hours.

  • It is possible to get an infection during or after a medication abortion. Infection can occur when bacteria makes its way into the uterus. This is uncommon, happening in less than 1 out of every 1000 people (<1%) having a medication abortion.

    It is important to pay attention to your body and listen to any instructions provided by your healthcare provider.

    You should contact an abortion provider or seek medical attention if you have a fever of 100.4 degrees or more for longer than 4 hours or if you are experiencing nausea, vomiting, diarrhea, dizziness, weakness, fatigue, or generally feeling unwell for beyond 24 hours after taking misoprostol.

  • This is the most common risk of medication abortion, happening in 3-7 out of every 100 people (3-7%). Medication abortion may fail (you could still be pregnant) or be incomplete (you could still have some pregnancy tissue inside your uterus).

    It is important to follow-up with a healthcare provider after having a medication abortion to ensure it was successful and that you do not need any further treatment.

    Signs of failed or incomplete abortion include having no bleeding or very light bleeding only after taking misoprostol, having continuing pregnancy symptoms after your abortion, heavy bleeding, passing multiple very large blood clots.

    To make sure your abortion was successful, closely monitor your symptoms and seek assistance if you have any concerns.

    Take a urine pregnancy test 5 weeks after a medication abortion. If it is positive you should seek follow-up care. Your health care provider may have different follow-up options availble to you including transvaginal ultrasound or serial hcg blood tests.

The use of heavy pads are recommended during a medication abortion. Tampons and menstrual cups may be used after the abortion has been completed (typically 24 hours after taking misoprostol) whenever the individual feels comfortable.

Some providers will offer medication abortion after 10 weeks into pregnancy, commonly up until 11 weeks (77 days). To reduce chance of incomplete or failed abortion, some providers will use a second dose of misoprostol starting around 9 weeks into pregnancy. Here is a sample instruction sheet from IPAS. This dosage is prescribed to be taken buccally (in the cheeks) 4 hours after the first dose of misoprostol.

There is growing evidence to suggest that medication abortion can be used safely and effectively even further into pregnancy, though medication abortion offered past 11 weeks in the United States is still uncommon.

For more information, please check out Reproaction for guides to medication abortion.

You can also visit ShareSafeAbortion.info.