How to use abortion pills
Reliable, evidence-based information about how to safely self-manage an abortion using pills
I think I’m pregnant. Can I use abortion pills?
This guide is most useful if you know that you are pregnant. If you are not sure you are pregnant, you can find out by taking a pregnancy test or getting an ultrasound. You may know you are pregnant if you are experiencing common pregnancy symptoms such as missing your menstrual period (monthly bleeding), tender breasts, nausea (with or without vomiting), frequent urination and feeling tired.
If you feel certain you are pregnant, then follow these steps:
- Identify the first day of your last menstrual period. This will help you know how many weeks pregnant you are. If you can’t remember the exact date, you can make your best guess. Think about special events, holidays, or anything unusual, different or important that may have been happening around the last time you had your monthly bleeding.
- Find out how many weeks pregnant you are. This information will guide how you use abortion pills. You can use an online pregnancy calculator (safe2choose.org has a good one) or a mobile app. You can also count on a calendar the number of weeks between the first day of your last menstrual period and today’s date.
- Find the right guidance for you below based on how many weeks pregnant you are.
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- LESS THAN 10 WEEKS: Abortion with pills is probably a good option for you, but please review the “Conditions to consider” section to make sure the pills are right for you.
- 10–12 WEEKS: You can use abortion pills, but you may need an extra 1–2 doses of misoprostol. It may be safest for you to use abortion pills with the help of a trained health-care provider. Be sure to review the “Conditions to consider” section to make sure the pills are right for you.
- MORE THAN 12 WEEKS: This guide does not provide guidance for pregnancies beyond 12 weeks. Abortion pills work at any stage of pregnancy, but at this stage an abortion will be safest with the help of a trained health-care provider. To avoid serious but rare complications, doses for pregnancy after 12 weeks are generally smaller (only two misoprostol pills, or 400mcg, at a time) with many more repeat doses needed.
Conditions to consider
Before you use abortion pills, make sure you don’t have ANY of the following:
- A serious illness or condition—like a heart condition, severe anemia, bleeding disorder, blood-clotting disorder, or adrenal failure.
- An intrauterine contraceptive device (IUD), such as a copper T or coil. (If you do, the IUD must be removed before you can use abortion pills.)
- Any pain or bleeding today. (If you are not taking the abortion pills today, make sure to think about this on the day you do take the pills.)
- A known allergy to the medications used for abortion with pills (mifepris- tone and misoprostol).
If you do have one of the above, you may still be able to use abortion pills, but you should have the guidance of a trained health-care provider.
Are you less than 12 weeks pregnant?
Do you have NONE of the conditions listed above?
Then abortion with pills is a good option for you.
How do I take abortion pills?
An abortion with pills uses a combination of the medications mifepristone and misoprostol. If mifepristone is not available, misoprostol can also be used alone. Without mifepristone, you will need to take more misoprostol pills, the process tends to be longer and you may experience more side effects.
If you are using MIFEPRISTONE AND MISOPROSTOL
1. Mifepristone
Swallow 200mg of mifepristone with water.
2. Wait 1–2 days
3. Misoprostol
Place 4 misoprostol pills (200mcg each, so 800mcg total) either under your tongue or between your cheek and gums (2 pills on each side of your mouth) for 30 minutes. After 30 minutes, swallow any remaining pieces of pills with water.
* If you are 10–12 weeks pregnant, you may need to take 1 or 2 extra doses of misoprostol to finish the process. To reduce pain and cramping, you can take ibuprofen before or just after taking the 4 misoprostol pills.
If you are using MISOPROSTOL ALONE
1. Take 4 misoprostol pills
Place 4 misoprostol pills (200mcg each, so 800mcg total) either under your tongue or between your cheek and gums (2 pills on each side of your mouth) for 30 minutes. After 30 minutes, swallow any remaining pieces of pills with water.
2. Wait 3 hours, then repeat Step 1
3. Wait 3 more hours, then repeat Step 1 again
In total, you will take 12 pills from start to finish.
*To reduce pain and cramping, you can take ibuprofen before or just after taking the 4 misoprostol pills.
What will happen when I take the pills?
The pills should cause bleeding and cramping, and you may see clots. Your bleeding may be more than your normal period. Every woman will experience bleeding and cramping differently.
You may have side effects.
Vomiting, headache, fever/chills and diarrhea are all common side effects. Most go away in a few hours. If any side effects last longer than a day, go to your nearest health worker.
When should I seek help?
If you have any of the following symptoms, see a health worker for additional care:
- Heavy bleeding or soaking more than 2 sanitary pads per hour for 2 hours in a row, especially if you feel dizzy, lightheaded and increasingly tired.
- Unusual or bad-smelling vaginal discharge, especially if you also have severe cramps or abdominal pain.
- Any of the following the day after you take the 4 pills of misoprostol:
- Fever
- Severe belly pain
- Feeling very sick with or without fever
- Persistent severe nausea or vomiting
How do I know the pills worked?
If you experienced bleeding and cramping and you no longer feel pregnant, the medicine has probably worked.
If you experience no bleeding or have little bleeding within 24 hours after taking the last misoprostol pills, it may mean the medicine did not work. To be certain, go to your nearest health worker for more help.
Answering these questions can help you feel confident that your abortion is complete—or help you decide to follow up with a trained health-care provider:
- Did you have cramping after you took the abortion pills?
- Did you have bleeding after you took the abortion pills?
- Did you pass tissue or see blood clots after you took the abortion pills?
- Did any pregnancy symptoms you had before taking the pills go away after taking the abortion pills?
If you answered “yes” to most of these questions, it is likely that your abortion was successful.
If you answered “no” to any of these questions, you may want to seek follow-up care with a trained abortion provider. It’s important to make sure your abortion is complete.
Important: If you said yes to the four questions above but want to confirm with a pregnancy test that the pills worked, wait until four weeks after taking the abortion pills. A pregnancy test may still have a positive result for up to four weeks after an abortion.
Sex and pregnancy after your abortion
You can have sex as soon as you like after an abortion with pills. You can become pregnant again as soon as 8 days after the abortion.
If you do not want to get pregnant, use contraception. Talk to a health worker. You can start most methods of contraception at the same time you take the abortion pills.
