How to use

Abortion pills can be an option in early pregnancy (generally within the first 12 weeks) if you are in good overall health. Before deciding, it’s important to review a few key factors:

• Confirm how many weeks pregnant you are, based on your last menstrual period or an ultrasound if available.
• Check for an IUD — if you currently have one, it needs to be removed before using the medication.
• Review any medication allergies, especially to mifepristone, misoprostol, or similar drugs.
• Consider existing health conditions, including bleeding problems, adrenal disorders, long-term steroid treatment, or use of anticoagulants (blood thinners).
• Rule out ectopic pregnancy, which requires different medical treatment.
• Ensure you can access medical care if you have heavy bleeding or other complications.

Discussing your medical history with a qualified healthcare provider can help you decide whether this method is safe and appropriate for you.

Cramping is a normal part of a medical abortion. The pain can range from mild to strong and is often heavier than a regular period, especially after taking misoprostol. Using pain relief can help you stay more comfortable during the process.

What You Can Take

• Ibuprofen (Advil, Motrin) – This is usually the most effective option for cramps. It can be taken before or when cramping begins.
• Prescription pain medication – In some cases, a healthcare provider may prescribe something stronger if needed.
• Anti-nausea medication – May help if you feel sick to your stomach.

What to Avoid

• Aspirin is generally not recommended because it can increase bleeding.

Comfort Tips

• Use a heating pad or hot water bottle on your lower abdomen.
• Rest in a comfortable position.
• Stay hydrated and eat light meals if you feel up to it.
• Have someone you trust nearby if possible.

If pain becomes severe and does not improve with medication, or if you experience very heavy bleeding, contact a healthcare provider right away.

Take one 200 mg mifepristone pill by mouth. You can take it with or without food. It’s normal if you don’t notice any immediate changes after taking it.

Mifepristone works by blocking progesterone, a hormone needed to maintain the pregnancy. This causes the uterus to start preparing for the next stage of the abortion process. Some people may notice light spotting, but heavy bleeding is not expected at this point.

Before using misoprostol, consider taking a medication for nausea, such as meclizine, about 30 minutes beforehand. This can help prevent or reduce queasiness and vomiting.

If you experience diarrhea, loperamide (Imodium) can help manage it. At the same time, taking 600–800 mg of ibuprofen can help reduce cramping before it starts, making the process more comfortable.

Take four misoprostol tablets (total 800 mcg) and place them either under your tongue, in your cheeks (buccal), or in the vagina. Let them dissolve for about 30 minutes, then swallow or rinse away any remaining pieces.

Cramping and heavy bleeding usually start within 1 to 4 hours. Passing blood clots is normal. The heaviest bleeding often lasts 2 to 6 hours and then gradually slows.

During this time:

• Stay at home and rest
• Have pads, a heating pad, pain relief, and water ready
• Do not use tampons
• If possible, have someone with you or available by phone for support.

This helps make the process safer and more manageable.

Misoprostol-only is a safe and effective option when mifepristone is not available or accessible. It is approved by the World Health Organization (WHO) for use in pregnancies up to 13 weeks.

When taken correctly with the recommended dose and timing, misoprostol-only is approximately 80–85% effective. In some cases, an additional dose may be needed if the first dose does not completely end the pregnancy.

If you have had a previous C-section, it is important to consult a healthcare provider before using misoprostol-only.

Q: Is pain worse with misoprostol-only?

Cramping may be stronger when using misoprostol alone compared to using both medicines together.

Q: What can I take for pain?

Take 600–800 mg of ibuprofen 30–60 minutes before your first dose. You can continue taking it every 6–8 hours as needed.

Q: Are there other ways to reduce discomfort?

Yes. A heating pad placed on the lower abdomen can provide additional relief.

About 30–60 minutes before placing misoprostol, you can take the following medications (if available) to help manage possible side effects and stay more comfortable during the process:

• Ibuprofen (600–800 mg): Helps reduce cramping and manage pain that may occur after taking misoprostol.
• Anti-nausea medication (such as meclizine): Can help prevent or lessen nausea and vomiting.
• Anti-diarrhea medication (such as loperamide/Imodium): May help reduce loose stools or diarrhea.

Taking these medications in advance can make the experience more manageable by minimizing common side effects.

Place 4 misoprostol tablets (800 mcg total) either under your tongue or between your gums and cheeks. Allow the tablets to dissolve for 30 minutes without eating or drinking. After 30 minutes, swallow any remaining fragments or rinse your mouth and spit out the leftover pieces if preferred.

If after 3 hours bleeding has not started or has been very light, take a second dose of 4 misoprostol tablets the same way as the first dose.

It’s common to experience chills and a mild fever for 1–2 hours after taking misoprostol under the tongue. These symptoms are usually temporary. However, if your temperature rises above 101°F (38.3°C) and lasts longer than 24 hours, contact a healthcare provider for further evaluation.

Always follow medical guidance specific to your situation and seek medical attention if you experience severe pain, very heavy bleeding, or other concerning symptoms.

Common side effects after taking abortion pills include:

• Cramping — (can be strong, similar to or heavier than a menstrual period)
• Heavy bleeding — with clots.
• Nausea
• Diarrhea
• Headache
• Vomiting

These effects are usually temporary and part of the process. However, seek medical attention immediately if you experience:

• Very heavy bleeding (soaking 2 or more pads per hour for 2 consecutive hours)
• Severe abdominal pain that does not improve with pain medication
• Fever of 38°C (100.4°F) or higher lasting more than 24 hours
• Foul-smelling vaginal discharge
• Signs of allergic reaction

If you have concerns or unusual symptoms, it’s important to contact a healthcare provider promptly.

After taking abortion pills, your body can recover quickly, and ovulation may happen sooner than you expect.

Having Sex

• You can have sex again when you feel physically and emotionally ready.
• Many healthcare providers suggest waiting about 1–2 weeks to reduce the risk of infection and allow bleeding to slow down.
• If you still have heavy bleeding or strong cramps, it may be best to wait.

Using Contraception

• You can ovulate as soon as 2–3 weeks after an abortion, which means you can become pregnant again quickly.
• Start contraception immediately or within 7 days after taking the abortion pills, depending on the method.

Options include:

• Birth control pills, patch, or ring – can usually be started right away.
• Condoms – can be used as soon as you resume sex.
• IUD or implant – can often be inserted soon after the abortion (consult a healthcare provider).
• Injection (Depo shot) – can be given immediately.

If you're unsure which method is best for you, speaking with a healthcare provider can help you choose the safest and most effective option.

It’s common to still feel pregnant for a short time after taking abortion pills. This can happen for several reasons:

1. Pregnancy hormones take time to drop:

The hormone hCG (human chorionic gonadotropin) does not disappear immediately. It can take several days to weeks for levels to fall, so symptoms like nausea, breast tenderness, or fatigue may continue for a while.

2. Breast tenderness or fullness

Your breasts may feel sore, swollen, or even leak a little milk, especially if the pregnancy was further along. This usually improves within a few days to a week.

3. Emotional and hormonal changes

Hormone shifts can affect your mood and body sensations. Feeling emotional, tired, or “off” is normal during recovery.

4. The abortion may still be in progress

Cramping and bleeding can last for several days. Passing clots or tissue is part of the process.

When to Take a Pregnancy Test

• A home pregnancy test can stay positive for up to 4–6 weeks because hCG takes time to clear.
• Most providers recommend testing about 4 weeks after taking the pills to confirm the abortion was successful.

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

Common Signs It Was Successful:

• Heavy bleeding and cramping within a few hours after taking misoprostol
• Passing blood clots or tissue
• Pregnancy symptoms improve (less nausea, reduced breast tenderness) within a few days
• Bleeding that gradually becomes lighter over 1–4 weeks