How to use

Abortion pills may be right for you if you are up to 12 weeks pregnant and do not have certain health conditions. Before taking abortion pills, consider:

• How far along your pregnancy is (confirmed by ultrasound or last menstrual period)
• Whether you have an IUD — it must be removed before taking pills
• Allergies to mifepristone, misoprostol, or similar medications
• Conditions such as bleeding disorders, adrenal gland problems, or use of blood thinners

If you are unsure, speak with a healthcare provider or contact our helpline for free, confidential guidance.

Cramping and pain are normal and expected. Prepare ahead of time to manage discomfort:

• Ibuprofen (Advil, Motrin) — 600–800 mg taken 30–60 minutes before misoprostol. Most effective OTC option for cramps.
• Heating pad — Applied to your abdomen or lower back to relieve cramping.
• Anti-nausea medication — Such as meclizine or Dramamine, helpful for nausea caused by misoprostol.

Avoid aspirin, as it can increase bleeding. Your provider may prescribe stronger prescription pain relief — do not hesitate to ask.

Take 1 mifepristone pill (200 mg) by mouth. You can eat before or after taking it. Most people have no symptoms right away — this is normal.

Mifepristone blocks the hormone progesterone needed for the pregnancy to continue, preparing the uterus for the next step. Some people experience light spotting, but heavy bleeding at this stage is uncommon.

Before placing misoprostol, take an anti-nausea medication such as meclizine (Dramamine Less Drowsy) 30 minutes ahead. This can significantly reduce nausea and vomiting.

You may also take loperamide (Imodium) for loose stools. Also take ibuprofen 600–800 mg at this time to pre-treat cramping.

Place 4 misoprostol pills (800 mcg total) under your tongue OR in your cheeks (buccal) OR in your vagina. Allow them to dissolve for 30 minutes, then swallow or rinse out any remaining pieces.

Cramping and heavy bleeding typically begin within 1–4 hours. Passing large clots is normal. The heaviest bleeding usually lasts 2–6 hours then slows significantly.

• Stay home, rest, and have supplies ready: pads, heating pad, pain medication, water.
• Do not use tampons during this process.
• Have someone with you or available by phone if possible.

Misoprostol-only is an option when mifepristone is not available or accessible. It is safe and effective for pregnancies up to 13 weeks and is WHO-approved.

• Effectiveness is 80–85% when used correctly with the right dose and timing.
• A second dose may be needed if the first does not work completely.
• If you have had a prior C-section, consult a provider before using misoprostol-only.

Pain management is especially important for misoprostol-only because cramping can be more intense than with the combination regimen.

Strongly recommended: Take 600–800 mg ibuprofen 30–60 minutes before your first dose. Repeat every 6–8 hours as needed. A heating pad on the lower abdomen provides significant additional relief.

30–60 minutes before placing misoprostol, take the following if available:

• Ibuprofen 600–800 mg to reduce cramping
• Anti-nausea medication such as meclizine to prevent nausea and vomiting
• Anti-diarrhea medication such as loperamide (Imodium) to prevent loose stools

Place 4 misoprostol pills (800 mcg) under your tongue or in your cheeks. Let them dissolve for 30 minutes, then swallow or rinse away any remaining pieces.

After 3 hours, if bleeding has not started or was very light, place 4 more misoprostol pills the same way (second dose).

Chills and low-grade fever for 1–2 hours are normal when taking misoprostol sublingually. If fever is above 101°F (38.3°C) lasting more than 24 hours, contact a provider.

Common side effects after taking abortion pills include:

• Heavy bleeding with clots — expected and normal, heavier than a period.
• Cramping — often strong. Take ibuprofen regularly for relief.
• Nausea and vomiting — especially with sublingual misoprostol use.
• Diarrhea — may occur within hours of taking misoprostol.
• Chills and low fever — common for 1–2 hours after sublingual misoprostol. Not a sign of infection by itself.
• Headache, fatigue, dizziness — mild and temporary.

Contact a provider immediately if you soak more than 2 pads per hour for 2+ consecutive hours, have a fever above 101°F lasting more than 24 hours, or have severe pain not relieved by ibuprofen.

You can become pregnant again as soon as 8 days after taking abortion pills — even before your next period. Start contraception as soon as possible if you want to prevent pregnancy.

• Condoms — can be used immediately once heavy bleeding has slowed.
• Hormonal pills, patch, ring, or shot — can start the same day or day after taking the pills.
• IUD — placed at follow-up once the abortion is confirmed complete.
• Implant — can be placed at any point.

Most providers recommend waiting until heavy bleeding has stopped (usually 1–2 weeks) before resuming sex to reduce infection risk.

Feeling pregnant — tender breasts, nausea, and fatigue — for up to 2–4 weeks after taking abortion pills is completely normal. Pregnancy hormones (hCG) remain in your body and take time to drop to non-pregnant levels.

A home pregnancy test may still show positive for several weeks after a completed abortion. This reflects lingering hormones, not an ongoing pregnancy.

If symptoms feel severe or are getting worse weeks later, contact a provider to confirm the abortion is complete via ultrasound or blood test.

The most reliable way to confirm a complete abortion is a follow-up ultrasound or serum hCG blood test 4 weeks after taking the pills.

Signs the abortion is likely complete:

• Heavy bleeding with clots in the days following the pills, then gradual reduction
• Pregnancy symptoms fading over 1–4 weeks
• A negative or very faint pregnancy test 4–5 weeks after the abortion

Contact a provider if heavy bleeding continues beyond 2 weeks, you still feel strongly pregnant after 4 weeks, or you develop signs of infection (foul-smelling discharge, fever, increasing pelvic pain).

Your next period will usually return in 4–6 weeks after a medication abortion. The first period may be heavier or lighter than usual — both are normal.

If you do not get a period within 6–8 weeks and a pregnancy test is negative, contact a provider, as this can indicate retained tissue or a hormonal imbalance.

The bleeding during the abortion is not your period. Your cycle resets from the day you took the medications.