There are two main ways abortion can be done: the abortion pill (also called medication abortion) and an abortion procedure (also called in-clinic abortion). Whether you have a medication abortion or an abortion procedure will depend on how far along you are in pregnancy, what the provider you choose offers, and also your own preference. We have more information about how to decide between these two types of abortion.
The abortion pill is generally available earlier in pregnancy. Each provider will have their own rules about how far along in pregnancy they’ll offer it–some will offer it through 13 weeks of pregnancy and others will stop offering it much earlier in pregnancy. Later on in pregnancy, your only option will be the abortion procedure.
You can get abortion pills from most in-person abortion providers. Depending on what state you’re located in, you may also be able to get abortion pills online using telehealth.
Medication abortion is often called the abortion pill, but in reality, it’s not just one pill. And there are multiple ways to use abortion pills to have an abortion. Depending on availability and other factors, it’s possible to use only one type of medication for a medication abortion, but the most effective and common kind of medication abortion in the U.S. involves taking two different medications.
How does taking the abortion pill work?
Here’s the most common way using abortion pills works when you get them from an in-person provider:
Step 1: Counseling, maybe an ultrasound, and maybe a waiting period
First you’ll fill out some paperwork. You’ll talk with a health care provider, and you may have an ultrasound to find out or confirm how far along you are in your pregnancy. If you are further along in pregnancy, then medication abortion may not be an option for you.
If the state where you’re getting your abortion has a mandatory waiting period, you’ll have to wait some number of hours between the counseling appointment and the appointment when you’ll take the first medication. If there is a waiting period, and you are going to have to travel a long way for your abortion, ask if virtual counseling is an option when you call to make your appointment.
Step 2: Take the first medication at a health center
Your health care provider will give you the first of two medications and explain when and how you’ll take the second medication.
The first medication is called mifepristone. Mifepristone blocks the hormone progesterone. Because progesterone is necessary for pregnancy to continue, blocking it starts the process of ending the pregnancy. Mifepristone doesn’t usually cause any symptoms, so you probably won’t feel anything after you take it. Your provider will give you the second medication to take up to 48 hours later. Make sure to follow the instructions the provider gives you because they may differ from one provider to the next.
Step 3: Take the second medication up to 48 hours later
Up to 48 hours after taking mifepristone, you’ll take a dose (which is usually four tablets) of the second medication, called misoprostol.
For this step, you need to be somewhere you can relax and where you’ll have easy access to a bathroom. Misoprostol empties your uterus, expelling the pregnancy. It causes cramping and bleeding.
You may take one or more doses of misoprostol depending on how far along you are and how your body responds to the first dose—your provider will let you know. Misoprostol starts working about 30 minutes to a few hours after you take it. When it kicks in, it’s normal to experience bleeding. The bleeding could range from medium to very heavy. You will likely pass some blood clots. You’ll also likely have cramps, which can be severe. You may also experience diarrhea or vomiting.
You can take over-the-counter pain medication, or your health care provider may prescribe a prescription-strength pain medication. But after a few hours, the symptoms will usually pass. Bleeding will decrease over the next few days. You can go back to work, school, taking care of your kids, or your other normal activities the next day. You can have sex again as soon as you’re ready.
You should get your next period within 6 weeks of having a medication abortion. If it’s been 8 weeks or more since your abortion, and you haven’t had a period, contact a health care provider.
Some health care providers will recommend a follow-up appointment a few weeks after your medication abortion to make sure the pregnancy is over. This appointment could take place via telehealth, a phone call, or in person, depending on the provider.
How much does an abortion with the abortion pill hurt?
Just like with the abortion procedure, how much an abortion with the abortion pill hurts varies from person to person. The pain may last for several hours, as the abortion itself takes longer to be completed with the abortion pill than with the abortion procedure, which usually takes just a few minutes. You can take over-the-counter pain medications or your provider may prescribe pain medication for you to take at home. In addition to pain medicine, you may find that using a heating pad reduces pain. Other techniques like breathing exercises and meditation can also help with pain.
For more help deciding between the pill and the procedure, check out our list of pros and cons for each abortion type.
When should you contact a health care provider after taking the abortion pill?
Your abortion provider should give you information about when and how to contact them after an abortion, but if they don’t, ask them for emergency contact information and for a list of things to watch out for.
Always reach out to your provider if something doesn’t feel right to you after an abortion or if you have questions or concerns.
Common side effects of medication abortion
Within 24 hours after you take the second medication (misoprostol), it’s normal to experience the following side effects:
Cramping
Bleeding
Fever
Chills
Nausea, vomiting or diarrhea
What to look out for
If it’s been more than 24 hours since you took the second medication (misoprostol) and you are experiencing any of the following, contact your abortion provider:
No bleeding yet
Excessive bleeding (This means soaking two pads per hour for two hours. Keep in mind though that it is normal for bleeding to be heavy and for you to pass blood clots.)
Fever higher than 100.4 F
Chills
Nausea, vomiting, or diarrhea
Pain that is getting worse or that isn’t going away with over-the-counter painkillers
