What is the abortion pill? The abortion pill is the use of medicine to end pregnancy. Studies show that the abortion pill works up to 63 days after the last period begins.
How does the abortion pill work? There are three steps. The first step, your clinician will give you a dose of methotrexate or mifepristone. The second step, you will take another medication called misoprostol. The third step, you will return to your clinician for a follow-up visit.
Step One
Methotrexate — stops the pregnancy in the uterus. It can also stop those that develop in the fallopian tube — ectopic pregnancies.
Mifepristone — blocks the hormone progesterone. Without progesterone, the lining of the uterus breaks down, ending the pregnancy.
Methotrexate and mifepristone affect the body differently. Mifepristone is used more often than methotrexate because it is more effective and more predictable. A clinician can help you decide which is best for you.
Step Two
Misoprostol — causes the uterus to contract and empty.
Step Three
Follow-up. Your clinician needs to make sure the abortion is complete. You will need an ultrasound or blood test.
How long does it take? The process of the abortion begins immediately after taking mifepristone or methotrexate. Some women may begin spotting before taking the misoprostol. For most, the bleeding and cramping associated with the abortion pill begins after taking the misoprostol.
More than 50 percent of women who use mifepristone abort within four to five hours after taking misoprostol. Heavy bleeding may continue for about 13 days. Spotting can last for a few weeks. About 92 percent of mifepristone abortions are competed within a week. Only 75 percent of methotrexate abortions are completed in that time — it may take up to four weeks.
It's important to remember that choosing the abortion pill means that you will need to visit your clinician's office more than one time.
How effective is it? The abortion pill with methotrexate is about 92-96 percent effective. With mifepristone, it is from 96-97 percent effective. Methotrexate and misoprostol can cause serious birth defects. If the abortion pill does not work, a vacuum aspiration abortion must be done. Vacuum aspiration ends a pregnancy by suctioning away the contents of the uterus.
What do I need to do to get the abortion pill? During the first visit, you will need to
discuss your options
sign a consent form
give a medical history
have laboratory tests
have a physical exam — including an ultrasound
You will also be given a medication guide to take home with you.
You will take the first medicine at the clinic. You and your clinician will plan the next step according to what is best for you. You may take the second medicine at home. Or you may need to return to the clinic.
After you take misoprostol you will start to bleed heavily within hours or days. This is the abortion.
How does it feel? For most women, the abortion pill is like an early miscarriage. You might
feel dizzy
feel strong cramps
feel nauseous or vomit
have diarrhea
feel temporary abdominal pain
have mild fever or chills
Acetaminophen — such as Tylenol or Excedrin — can reduce most of these symptoms. Painkillers such as ibuprofen — for example, Motrin or Advil — can also reduce symptoms. Do not take aspirin. You may see large blood clots or tissue at the time of the abortion. You may have some bleeding for up to four weeks after. In general, your bleeding should get lighter and lighter. You may use pads or tampons during the abortion pill, but using pads makes it easier to keep track of your bleeding.
What are the risks of the abortion pill? The abortion pill is safe. But there are risks with any medical procedure.
Risks associated with the abortion pill include
incomplete abortion — your clinician will help you decide whether to
wait two-to-six weeks and check again
take more misoprostol
have a vacuum aspiration
allergic reaction
infection
very heavy bleeding
undetected ectopic pregnancy, which can be fatal if left untreated
in extremely rare cases death is possible from very serious complications
Contact your clinician right away if at any time you
have a fever of 100.4° F or higher that lasts for more than four hours
have heavy vaginal bleeding and are soaking through more than two maxi pads an hour, for two hours or more in a row
have clots for two hours or more that are larger than a lemon
bleed heavily for more than 12 hours in a row
throw up for more than four to six hours and are not able to keep anything down
have abdominal pain or discomfort not helped by medication, rest, hot water bottle, or heating pad
You should start to feel better each day after the abortion. Feeling sick — including weakness, nausea, abdominal pain or discomfort, vomiting, or diarrhea — more than 24 hours after taking misoprostol could be a sign of serious infection. Contact your clinician right away if you have any of these symptoms. Do not wait for your follow-up appointment.
You may need another visit with your provider. Rarely, women need vacuum aspiration or hospitalization. Take your medication guide with you if you need to visit a clinician who did not give you the medicine.
Why do some women prefer the abortion pill?
There's no anesthesia.
It can be done early — women can begin treatment as soon as they know they are pregnant.
Women may feel more in control — many feel it is less invasive.
Women may feel it's more "natural" — many feel it is more like miscarriage.
There's more privacy — women may have the abortion at home.
Ninety-seven percent of women who have had the abortion pill would recommend the method to a friend.
Who can choose the abortion pill? You may choose the abortion pill if you
are up to 63 days pregnant
agree to have a vacuum aspiration abortion if the abortion pill fails
have access to a telephone, transportation, and back-up medical care
are willing to have your IUD — if you have one — removed before taking the medicine
You should not use the abortion pill if you
are more than 63 days pregnant
are unwilling or unable to have a vacuum aspiration abortion if the abortion pill is incomplete
cannot return for follow-up visits
have a known or suspected molar pregnancy — one in which the placenta develops cysts and the embryo either does not form at all or develops abnormally
have an allergy to the medications
have severe adrenal gland, heart, kidney, or liver problems
take any medicine that should not be combined with methotrexate, mifepristone, or misoprostol
take anti-clotting medication or have blood-clotting disorders
You may not be able to use the abortion pill if you
are 35 or older and smoke 10 or more cigarettes a day
are breastfeeding
have chronic heart, liver, respiratory, or kidney disease
have a condition that would prevent you from having a vacuum aspiration abortion, such as large uterine fibroids
have severe anemia
have uncontrolled high blood pressure
have uncontrolled inflammatory bowel disease
Will I need to prepare for the follow-up? Yes. After you take the medicine and before your follow-up exam
Do not take a vitamin with folic acid. (methotrexate only)
Do not take aspirin.
Do not take anti-coagulant (anti-clotting) drugs.
What if I'm still pregnant after taking the medicine? Your clinician will help you decide. You may
wait two to six weeks and check again
take more misoprostol
need a vacuum aspiration abortion
When will I get my period? Abortion begins a new menstrual cycle. You should have a regular period in four to eight weeks.
When can I have sex again? Don't have vaginal intercourse or insert anything except a tampon into the vagina for one week after the abortion. You can get pregnant very soon after the abortion. Discuss birth control options with your clinician.
Where can I get the abortion pill? Contact Planned Parenthood at 1-800-230-PLAN, other women's health care centers, or your private clinician. Planned Parenthood centers that do not provide the abortion pill can refer you to someone who does.
How much does it cost? The abortion pill involves two or three office visits, testing, and exams. Nationwide, the cost of the abortion pill ranges from $350 to $650. Costs may be more or less depending on locale and whatever additional tests, visits, or exams are needed. Costs vary from community to community, based on regional and local expenses. Contact your nearest Planned Parenthood health center 1-800-230-PLAN for information about costs in your area.
Sexuality and relationship info you can trust from Planned Parenthood® Federation of America
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