Self-Managed Abortion with Pills
The content on this website is for informational purposes only.
There are various ways a person might self-induce an abortion, but self-managing a medication abortion is the safest and most effective according to the World Health Organization (WHO). Before deciding to self-manage a medication abortion, there are many factors to consider. The pregnancy would need to be confirmed and the gestational age measured (counting the days since the first day of the last period). There are two regimens for medication abortion, according to the WHO: mifepristone with misoprostol, and misoprostol only.
The WHO says that medication abortion is not appropriate for everyone, specifically those who have had an ectopic pregnancy (the embryo implanting outside of the uterus), pelvic inflammatory disease, chronic adrenal failure, hemorrhagic disorders, bleeding disorders, porphyries, those who currently have an IUD (intrauterine device, which must be removed before taking pills), or those who are experiencing pelvic pain. If a person has any of these health issues, they should reach out to a medical professional before taking the medicines. A person should also understand how medication abortion works and how to correctly use the medicines involved.
Resources
Repro Legal Defense Helpline
(844) 868-2812
The Repro Legal Defense Helpline offers legal information to anyone who is concerned about the legal risks of self-managing an abortion.
M+A Hotline
(833) 246-2632
If you have medical questions about your experience in the moment the Miscarriage + Abortion Hotline provides text or phone medical advice from volunteer doctors during a miscarriage or abortion.
Pills & Information
These organizations offer more resources on self-managing an abortion, including pills!
I Need An A
Looking for an abortion? INeedAnA.com is the best website to help you figure out where your nearest clinic is, how to order abortion pills, how to you can get help paying for an abortion, and what laws you should be aware of when getting care. It’s super easy to use, they don’t keep or share your data, and it was created by someone who had an abortion!
Euki App
Need a period tracking app that won’t compromise your privacy? Have questions about self-managing your abortion or STIs? Euki brings reliable, evidence-based sexual and reproductive health information where it belongs: in your hands. With verified insights you can trust, you can make decisions about your health that are right for you. And it’s in English and Spanish!
The content on this page is for informational purposes only and is not legal advice or medical advice.
The Legality.
While a person having an abortion on their own with pills is relatively safe, it can be legally risky. A person thinking about doing this—and their support person—should be very careful not to talk to law enforcement about their plans as it could have legal consequences for everyone involved. If a person has a complication and wants to go to a hospital, they do not need to tell the staff that they tried to self-manage their abortion. There is no way to tell whether a person took medication abortion pills, so they should just tell their medical provider that they are having a miscarriage. The treatment for a medication abortion complication is the same as the treatment for a miscarriage. There is no test that can detect either drug, so there is no reason to tell a medical provider about self-managing an abortion and is often helpful to say that it is a miscarriage.
All hospitals know how to handle this as miscarriages occur in 15-20% of all pregnancies. However, the healthcare professional will become aware if the patient discloses the truth or has the pills in their body (detectable in the vagina, but rarely in the mouth) which could put them in legal jeopardy.
A person researching self-managed abortion may want to limit what information they search for through Google or social media sites where privacy may not be secure. A VPN can give users privacy online. Signal is an encrypted text and voice app that many use to communicate, and it provides more security than using a phone’s messaging system.
The Pills.
Be Careful of Scams: Some websites say they offer these medicines (often a combination package) for purchase but be careful of scams exploiting people who are desperate.
Mifepristone (used with Misoprostol)
What it is: A pill that ends a pregnancy
What it does: Stops the production of progesterone, a hormone that grows the pregnancy
Where it is available: Mifepristone is commonly obtained online or in community markets, although it is legally risky to obtain. In Mexico and other Latin American countries, prescriptions aren’t usually required.
Side effects: rare; some experience nausea, dizziness or light bleeding
Common names: Mifeprex
When can it be used: up to 12 weeks of pregnancy, according to the WHO
How effective it is: 95-99% effective in the first 10 weeks of pregnancy
Misoprostol (can also be used alone)
What it is: It prevents ulcers in people with conditions like arthritis and treats ulcers/arthritis in dogs
What it does: Causes contractions and expels the pregnancy
Where it is available: Pharmacies with a prescription and some online veterinarian websites
Common names: cytotec, cyrux
When can it be used: up to 9 weeks of pregnancy, or further with additional doses, according to the WHO
How effective is it: 75-85% effective in the first 12 weeks of pregnancy. Best when used after 5-6 weeks of pregnancy.
Additional info: When purchasing, if asked, it is recommended to say the pills are for a family member with an ulcer or arthritis. In Canada, online pharmacies offer it inexpensively, but some require prescriptions.
The Prep.
For a person considering self-managing their abortion with pills, it’s also highly recommended that the person makes a plan, including finding a loved one to support them through the process. This helper can ensure the person having the abortion is able to reach out to a health care provider within two hours in the rare case of a complication. It can also be helpful for a person to discuss the directions with another person—perhaps a loved one or friend—to make sure everyone involved clearly understands and has reviewed all the information and instructions about medication abortion pills.
A person seeking to manage their own abortion should have:
Large maxi pads, NOT tampons: Maxi pads will also allow for an accurate measurement of how much the person is bleeding. Tampons can cause a possible infection.
Pain medications like Aleve or Advil, NOT aspirin: Pain medications include other names like Ibuprofen, NSAIDs, Naproxen, and Diclofenac
A hot water bottle or heating pad
Anti-nausea medication to avoid vomiting up the pills
A toilet nearby
Pillows and a comfortable area to rest
Food or snacks: No heavy meals and no alcohol. A person can eat and drink normally the day of their abortion, as no empty stomach is needed.
Thermometer: To keep track of temperature as an extended fever can be a sign of infection
A friend
Time: Medication abortions take several hours, so a person should plan to make sure that it fits into their schedule.
The Process.
(According to the World Health Organization)
A person should choose one of the following methods.
Method: Mifepristone & Misoprostol
95-99% effective, up to 12 weeks of pregnancy
A person would swallow one mifepristone tablet (200 milligrams).
24 hours later (can be up to 48 hours), a person would place 800 micrograms misoprostol (four (4) 200 micrograms misoprostol tablets) in the cheeks between the gums and cheek without swallowing the pills for 30 minutes.
Afterward, the person would swallow any part of the pills that did not dissolve.
If someone is over nine (9) weeks, they should repeat the misoprostol dose four (4) hours later.
A person can dissolve the misoprostol pills inside their vagina, however remnants of the misoprostol could be detected by police and medical providers.
Method: Misoprostol Only
Most effective if used after 5-6 weeks of pregnancy
A person places four (4) misoprostol pills under the tongue or between the cheeks and gums, without swallowing, and lets it dissolve for 30 minutes.
They should not swallow whole pills, but can swallow the remaining undissolved pieces after 30 minutes.
A person would repeat this step two (2) times every 3 hours until they have taken all twelve (12) misoprostol pills.
Dose: 12 tablets (200 mcg)
First round: 4 tablets for 30 minutes
Second round, 3 hours later: 4 tablets for 30 minutes
Third round, 3 hours later: 4 tablets for 30 minutes
Some people may require additional doses of misoprostol. More information below.
A pregnant person may experience intense cramping and heavy bleeding. Some people, not everyone, will experience some very uncomfortable symptoms; these typically mean the medication is working, and can include: nausea, dizziness, vomiting, diarrhea, light fever and chills, headache.
Important Information on Complications
A person should see a doctor if:
they have bleeding that soaks through two full-size pads per hour for two consecutive hours
they experience dizziness that does not go away
there is an unusual vaginal discharge
they have a temperature over 100.4 degrees Fahrenheit
they’ve only had light or no bleeding two days after taking misoprostol
they experience severe pain that does not go away
Complications are rare, however, if a person needs to go to the hospital, they can say they are having a miscarriage. There’s no way for medical experts to tell the difference. While having an abortion at home using pills is medically safe, it can be legally risky. People have been arrested for taking abortion pills on their own. While it is not possible to test for abortion pills that are ingested in the mouth, it is possible that remaining undissolved parts of pills can be observed in the vagina if the misoprostol pills are placed there.
YOU DO NOT NEED TO TELL ANYONE THAT YOU HAVE TAKEN ABORTION PILLS.
Medicaid and most insurance plans cover treatments for a miscarriage.
The information on this page is for informational use and is not legal or medical advice.
Additional Information About Misoprostol-Only Abortion Regimens
When using a misoprostol-only method, some people may require additional doses of misoprostol to complete the abortion, particularly later in pregnancy.
If no bleeding has occurred after 3 doses (above), take another dose (4 tablets for 30 minutes). If no bleeding has occurred, take another dose (4 tablets for 30 minutes).
If a person is between 5-9 weeks of a pregnancy, and after 3 doses a person has only bled a little, they should take another dose (and possibly another) until bleeding starts. If they have bled and cramped but are not sure that the pregnancy has passed, they should wait 48 hours and assess pregnancy symptoms. If they still feel pregnant, they should take another 2 doses (4 tablets for 30 minutes per dose).
Ectopic Pregnancy: If extreme pain on one side arises, seek care immediately as this is a sign of an ectopic pregnancy which are a rare occurrence. If no bleeding has occurred after 48 hours (and 5 doses) a person may want to seek out an ultrasound to check for an ectopic pregnancy. A person should be careful when requesting an ultrasound and do their best not to share their intentions for the pregnancy so as not to raise suspicions. A person would simply describe the symptoms they are feeling and request an ultrasound.
It is recommended that a person wait until they are at least 5 weeks into their pregnancy to use a miso-only regimen.
