By: Claire

You’ve decided you want to have an abortion with pills, but you’re not sure what to expect. Will there be pain? How long will it last? What’s normal, and what are signs that something’s not right?

Before terminating a pregnancy, it’s important that all women are fully informed about the abortion process. Anticipating and recognizing common symptoms during the abortion will not only help to reduce stress and anxiety, it can also lead to a safer abortion experience. In today’s blog, let’s debrief what to expect during an abortion with pills.

Reviewing Medical Abortion

There are two medications that can be used for an abortion with pills: mifepristone and misoprostol. Mifepristone can be used together with misoprostol to terminate a pregnancy, or misoprostol can be used in repeated doses by itself. Regardless of which method you choose, be sure that follow the correct protocols. Misusing the abortion pills can be unsafe for the woman and potentially lead to an unsuccessful abortion.

What To Expect After Using Mifepristone

There are not many effects associated with mifepristone. Some women report light bleeding after using the medication, while others report no effects at all. Both are normal experiences, and neither should alarm you.

Mifepristone may occasionally cause feelings of nausea. If a woman vomits within 1 hour of swallowing mifepristone, it likely will not work and she can try taking the medication again. If she vomits after 1 hour of swallowing mifepristone, the medication most likely had enough time to absorb into the body and there is no need to repeat the dose.

What To Expect After Using Misoprostol

Unlike mifepristone, the effects of misoprostol are very obvious and indicate that the medication is working as expected.

Bleeding will usually begin 1-3 hours after using misoprostol. Expect bleeding that is as heavy or heavier than your typical menstrual period. As a general rule, know that the further along a pregnancy is, the heavier you can expect the bleeding to be. This bleeding will commonly include clots.

The heaviest bleeding typically occurs between 4-6 hours after using misoprostol. Within 24 hours, the bleeding will most likely have decreased. However, know that it is common for women to continue bleeding for several weeks after the abortion. This is normal.

Cramping will also accompany the bleeding. Cramps result from the uterus contracting to push out the pregnancy. Just like bleeding, cramping is a sign that the abortion is proceeding as expected.

The most severe cramping usually occurs within the first 4-8 hours of using misoprostol. After that, cramps may lessen and gradually disappear.

Remember that you can anticipate cramping and take pain killers 30 minutes before using misoprostol to help reduce the pain. You can find other ways to manage discomfort during the abortion process here.

Aside from cramping and bleeding, women may also experience nausea, dizziness, diarrhea, headache, or a temporary rise in their temperature after using misoprostol. All of these are normal, and can be cared for through rest, hydration, and gentle, nourishing foods.

What Is Not Normal During An Abortion

Knowing which signs suggest that something is not right during an abortion is just as important as knowing what expect.

Though heavy bleeding is normal, excessive bleeding is a sign of potential hemorrhage and needs immediate treatment. If a woman completely soaks two regular menstrual with blood in one hour for two hours straight- meaning that 4 pads are thoroughly soaked within 2 hours- she needs to seek emergency care. This type of bleeding can be life threatening.

Prolonged intense pain that does not go away with pain medication and/or continuing to feel very sick for several days after using misoprostol can also be a warning sign of complication. Seek medical care.

On the other side of the spectrum, little or no bleeding is not normal after an abortion with pills. Abortions that do not cause bleeding likely did not work. The question, though, is why the abortion did not work. For these types of situations, we like to refer to our friends at They have a team of trained abortion counselors that can help women understand their specific abortion experience and determine best next steps.

Lastly, monitor yourself for any signs of infection. Though feelings of nausea, fatigue, and a temporary spike in temperature are normal, they should not last more than 24 hours after using misoprostol. Similarly, any vaginal discharge that is yellow, green, or smells foul can also signal infection. Talk to a care provider to determine next steps.

If you are looking to learn more about safe medical abortion, you can visit our website or send us an email at You can also follow us on social media: we’re on FacebookInstagramTwitter and Pinterest.

Claire is a teacher, reproductive rights advocate, and the manager of