Using Abortion Pills on Your Own: What to Expect

NAF member telehealth abortion providers generally recommend mifepristone 200mg (1 pill) by mouth, followed in 24 to 48 hours by misoprostol 800mcg (four pills) in the cheeks for two to three doses every four hours. Some providers may have slightly different ways of taking pills. If you are concerned, please reach out to the clinic or provider who sent you the medication to ask them about how to take them. Using misoprostol only without mifepristone is less effective than using both types of medication together.

Four misoprostol tablets may not be enough to effectively end your pregnancy. It’s more effective to get a new prescription for all of the medication, which includes both mifepristone and misoprostol. 

You can use abortion pills as soon as you know you are pregnant, usually three and a half to four weeks after the first day of your last period. The pills may be slightly more effective if you wait to take them five to six weeks after the first day of your last period.

Most online pill providers don’t provide medication once a person is 11 to 12 weeks after the first day of their last period. It may be safer to do an in-clinic abortion later in pregnancy.

Most people do not have bleeding or cramping after the first pill (mifepristone). Bleeding and cramping start for most people 1-2 hours after the second set of pills (misoprostol). It may take up to 24 hours after misoprostol for bleeding and cramping to happen.

Everyone is different. Some people experience heavy bleeding and pass large clots (the size of a lemon) and others have bleeding that is more like a period. If someone is early in pregnancy (less than six weeks from their last menstrual period) they may have only a small amount of bleeding. Any bleeding at all is a reassuring sign that the medication is working.

If you are soaking through two heavy maxi pads (completely soaked front to back) for two straight hours, you may need to call your provider or seek help.

Any bleeding is a good sign that the medication is working. If you have no bleeding at all, it may be a sign that the medication is not working and you should contact your provider.

You cannot see any fetal tissue until you are about 10 weeks pregnant, and even then, the fetal tissue is very small and transparent and may be wrapped in blood clots or tissue. Usually people will see blood, blood clots, and pinkish tissue.

Everyone is different. Some people experience severe and painful cramping while others have milder pain and cramping. Using ibuprofen and paracetamol (Tylenol), hot packs, and a warm shower may help ease the pain and cramping. The most painful cramping usually lasts an hour or two while the pregnancy is passing.

Misoprostol can cause nausea, vomiting, and diarrhea. It can also cause you to feel chilled or shaky and have a slight fever. These are normal side effects of the misoprostol and should resolve within 24 hours.

If you have a fever >100.4F 24 hours after taking misoprostol, please call your provider or seek care from your doctor or the emergency room.

First, check with your provider if you need to seek emergency care. They can help you understand if things are normal or not. If you feel like you need to go to the emergency room and can’t share that you used medication abortion, you can say “I had a positive pregnancy test and I’m now having a lot of bleeding. I want to check that I’m OK.” There is no test that can detect the medications in your system. You only need to tell someone that you used medication if you feel comfortable.

If you have bleeding and cramping, that’s a good sign. If your pregnancy symptoms like nausea go away, that’s also a good sign. Breast tenderness may take a little more time to resolve. You can follow-up with your own doctor for blood testing or ultrasound to see if everything worked or you can take a pregnancy test five to six weeks after the abortion; however, most people know that the abortion worked because they no longer feel pregnant.

If you do not have bleeding or cramping and you are still feeling pregnant after taking the medication, the medication may not have worked. You should contact your provider to see what to do next. They may recommend another round of medication.

Don’t take a pregnancy test until about five to six weeks after using the medication. It takes a little while for the pregnancy hormone to leave your body, so the test is positive after an abortion for a while even if the medication worked.

Yes! You should eat and drink what tastes good to you. Stay hydrated. Some people may want to eat lighter, less greasy foods because the process can cause some nausea.

If cannabis helps you with pain and anxiety, you can use it. If you are not a regular user, now is not the time to start. If you decide to use cannabis, remember to “start low and go slow” so you can see how you feel.

People can have bleeding and cramping that comes and goes for a month or more after taking medication abortion. Bleeding and cramping may stop for a few days and then return. That’s normal.

Most people’s period returns in six to eight weeks after taking medication abortion. The first period may be heavier or longer than usual with a change in color or clotting.

After medication abortion you can do any activity that you feel ready to. There are no restrictions on activities. Listen to your body—if you are tired, you may want to do lighter activities until you feel ready. If you do heavier activities and your bleeding and cramping get worse, rest a little bit and try again tomorrow.

If you start birth control within five days of taking the first pill, you will be protected the next time you decide to have sex.