Medication Abortion

Medication abortion is when a pregnancy is terminated through the use of specific medication.

During the first trimester, a medication abortion may be an option for you, but this will also depend on state laws (which you can check here). Generally, you can get a medication abortion up to 70 days (10 weeks) from the first day of your last period, but some states are permitted to provide medical abortions up to 11 weeks. According to the World Health Organization, you can self-manage with pills up to 12 weeks.

A medication abortion works by stopping the growth of pregnancy and emptying your uterus, just like a miscarriage (also known as a “spontaneous abortion”). Before your abortion, a health technician may take some blood and do an ultrasound to see if the abortion pill is right for you. During your abortion appointment, you will take the first tablet of mifepristone (a.k.a. Mifeprex, 200 micrograms) which will help the pregnancy detach from your uterus by stopping your body from producing progesterone, a hormone needed to grow a pregnancy.

Remember, most people don’t have side effects from this medication, but it’s still normal to feel dizzy, nauseous, or have light to moderate bleeding and cramping. You can ask the clinic for a pad or nausea medication if you’re concerned you may experience one of these uncommon side effects. 

Then, 24-48 hours later, you’ll place 4 tablets of misoprostol (200 micrograms each, 800 micrograms total) in between your cheeks and gums, or under your tongue, or in your vagina at home for 30 minutes. This medication will cause your uterus to have contractions and expel the pregnancy similar to a heavy period or miscarriage.

In some cases, you may only take misoprostol as it can cause an abortion on its own by placing a series of 12 misoprostol pills (200 micrograms each) in between your cheeks and gums, or under your tongue, or in your vagina 4 at a time for 30 minutes every three hours. Some people may need to take additional doses of misoprostol in the same way, and may need to wait a few days for the abortion to start.

While everyone handles pain differently, you will probably experience up to 12 hours of mild to intense cramping and a heavy amount of bleeding with blood clots up to the size of a lemon. It’s possible to see pregnancy tissue during the process, which can include maternal tissue, a gestational sac, and a small embryo or fetus depending on how many weeks into pregnancy you are. Misoprostol can cause a slight fever, chills, and/or nausea. This is all normal, but if you feel body aches, fatigue, or other flu-like symptoms, your provider should have given you a phone number to use for this very reason.

Most people pass the pregnancy within 12 hours, but it may take longer. Call your provider if you haven’t experienced any bleeding, or have only had light bleeding, in 48 hours. You may need additional misoprostol to start the process. Expect to have some bleeding and spotting for 2-8 weeks afterward. Many people can also tell the abortion is complete by their pregnancy symptoms alleviating, or because their heavy bleeding and cramping have slowed down. However, still, attend any follow-up appointments your provider schedules for you to ensure the abortion was successful.

Patients report that with the medication abortion they tend to feel a greater sense of control. The abortion is completed within the privacy of your own home and you can choose when to do it and who to have with you. But the medication abortion process takes longer and there is a slim chance (1-3%) that it won’t be successful, so make sure you’re prepared for the follow-up appointment (usually 10-14 days from your abortion)!

Medical abortions are extremely safe, and despite the fear-mongering perpetuated by people who don’t like abortion, there’s only a 0.4% chance of major complications, which include: continuation of pregnancy, retained products of conception in the uterus, blood clots in the uterus, excessive bleeding, infection, and allergic reaction to pills.