There are two main ways abortion can be done: the abortion pill (also called medication abortion) and an abortion procedure (also called in-clinic abortion). Whether you have a medication abortion or an abortion procedure will depend on how far along you are in pregnancy, what is offered at the clinic you choose, and also your own preference. We have more information about how to decide between these two types of abortion.
The abortion pill is effective until the 11th week (77 days) of pregnancy, but each clinic will have their own rules about how far along in pregnancy they’ll offer it. After that time, your only option will be the abortion procedure.
Medication abortion is often called the abortion pill, but in reality, it’s not just one pill. You actually take two different medications one or two days apart. Here’s how it works:
How does taking the abortion pill work?
Step 1: Counseling, maybe an ultrasound, and maybe a waiting period
First you’ll fill out some paperwork. You’ll talk with a health care provider, and you may have an ultrasound to find out or confirm how far along you are in your pregnancy. If your pregnancy is more than 11 weeks along, then medication abortion won’t be an option for you.
If the state where you’re getting your abortion has a mandatory waiting period, you’ll have to wait some number of hours between the counseling appointment and the appointment where you’ll take the first medication at the clinic. If there is a waiting period, and you are going to have to travel a long way for your abortion, ask if virtual counseling is an option when you call to make your appointment.
Step 2: Take medication #1 at a health center
Your health care provider will give you the first of two medications and explain when and how you’ll take the second medication.
The first medication is called mifepristone. Mifepristone blocks the hormone progesterone. Because progesterone is necessary for pregnancy to continue, blocking it begins the process of ending the pregnancy. Mifepristone doesn’t usually cause any symptoms, so you probably won’t feel anything after you take it. The abortion provider will send you home with the second medication, which you’ll take 24 to 48 hours later, depending on the instructions the provider gives you.
Step 3: Take medication #2 at home or somewhere safe
Twenty-four to 48 hours after taking mifepristone, you’ll take the second medication, called misoprostol. You may take one or two doses of misoprostol—your provider will let you know. For this step, you need to be at home or in some other safe place where you can relax and where you’ll have easy access to a bathroom (like a friend’s house or a hotel room). Misoprostol empties your uterus, expelling the pregnancy. It causes cramping and bleeding.
Misoprostol starts working 30 minutes to a few hours after you take it. When it kicks in, it’s normal to experience bleeding. The bleeding could range from medium to very heavy. You will likely pass some blood clots. You’ll also likely have cramps, which can be severe. You may also experience diarrhea or vomiting. You can take over-the-counter pain medication, or your health care provider may prescribe a prescription-strength pain medication. But after a few hours, the symptoms will pass. Bleeding will decrease over the next few days. You can go back to work, school, taking care of your kids, or your other normal activities the next day. You can have sex again as soon as you’re ready.
Some health care providers will recommend a follow-up appointment a few weeks after your medication abortion to make sure the pregnancy is over. You should get your next period within 6 weeks of medication abortion. If it’s been 8 weeks or more since your abortion, and you haven’t had a period, contact a health care provider.
Some health care providers prescribe preventive antibiotics for all people having an abortion.
Note: With the ongoing COVID-19 pandemic making in-person appointments more difficult, some health care providers may start prescribing medication abortion through telehealth appointments. Ask whether this is an option when you make your appointment. You may also qualify to participate in a study run by TelAbortion that allows you to have a medication abortion entirely from home. You do the counseling with a health care provider via telehealth and then have the medications mailed to you to take at home. Keep in mind that it is only available in certain states and only available if you are less than 70 days (10 weeks, 0 days) pregnant.
How much does an abortion with the abortion pill hurt?
Just like with the abortion procedure, how much an abortion with the abortion pill hurts varies from person to person. It may last for several hours, as the abortion itself takes longer to be completed with the abortion pill than with the abortion procedure, which usually takes just a few minutes. You can take over-the-counter pain medications or your provider may prescribe pain medication for you to take at home. In addition to pain medicine, you may find that using a heating pad reduces pain. Other techniques like breathing exercises and meditation can also help with pain.
For more help deciding between the pill and the procedure, check out our list of pros and cons for each abortion type.
When should you contact a health care provider after taking the abortion pill?
Your abortion provider should give you information about when and how to contact them after an abortion, but if they don’t, ask them for emergency contact information and for what things to watch out for.
You should always reach out to your provider if something doesn’t feel right to you after an abortion or if you have questions or concerns. And you should definitely contact your abortion provider (or your regular health care provider) after taking the abortion pill if you experience:
No bleeding yet and it’s been 24 hours since you took the second medication (the one you take at home)
Excessive bleeding (defined as soaking two pads per hour for two hours; keep in mind that bleeding may be heavy and you may pass blood clots though)
Fever higher than 100.4 F
Nausea, vomiting, or diarrhea that continues for more than 24 hours after taking the misoprostol, the second medication, which you take at home (keep in mind that nausea, vomiting, and diarrhea are considered normal side effects and are not a cause for concern in the first 24 hours after taking misoprostol)
Pain that is getting worse or that doesn’t go away with over-the-counter pain medication