Abortion Questions – Abortion Pill FAQs

Who Can Use Abortion Pills?

    No, use the same number of pills we recommend for everyone. Studies have shown that the success of the medication doesn’t decrease if you are overweight. You don’t need to take a different dose or more pills.

    You don’t need to change the dose or the number of pills if you find out you’re pregnant with twins. The same procedure is used for twin pregnancies

    No, each pregnancy is a unique event. If you used the abortion pills before, you don’t need a higher dose if you use it again for a different unwanted pregnancy.

    If you have an intrauterine contraceptive device in the uterus (e.g. the coil or the progesterone IUD), you must get it removed before your medical abortion.

    You can breastfeed as normal when having an abortion with pills. Mifepristone and misoprostol can enter the breast milk, but the amounts are small and it should not cause any side effects in the baby. If you are still nervous about it, you can breastfeed the baby, take the misoprostol pills, and wait 4 hours before you breastfeed again. If you need to take another round of misoprostol pills, breastfeed again before taking the pills. However, this is completely optional and up to your preference.

    If you are living with HIV, just make sure you’re on antiretroviral medicines and your health is good.

    If you have anemia (low iron levels in your blood), identify a health care provider who is no more than 30 minutes away that can help if you need it. If you are very anemic, consult a doctor before using the abortion pill.

    No, using abortion pills early in pregnancy is safe even if you had a previous C-section delivery.

    There has been no link found between mifepristone and birth defects. However, misoprostol does cause a slightly increased rate of birth defects. If you take misoprostol and you are still pregnant after taking the pills, you might have a natural miscarriage. If you do not have a miscarriage and carry the pregnancy to term, the risk of birth defects increases by 1% (one baby in 100).

    No, it is not safe to use abortion pills if you know that you are at risk for ectopic pregnancy. Because you had a tubal ligation, we know there is scarring in your tubes (Fallopian tubes). That’s probably why your last pregnancy was an ectopic pregnancy. The Fallopian tubes are where an egg is fertilized with a sperm. The pregnancy starts to grow and move along the tube to the womb. If your tube is scarred, the early pregnancy can get trapped in the tube. As the pregnancy grows, it can cause the tube to break open. If the tube breaks open, this can cause major bleeding inside you, which is life threatening. You are at risk for another ectopic pregnancy. You should not use the abortion pills on your own until you have an ultrasound and are sure that the pregnancy is in the womb, not in your tubes.

    First, you must know that you might not be aware of this condition unless you have had an ultrasound. Ectopic pregnancies are not viable so even in countries where abortion is not legal you could have access to a legal procedure to terminate this pregnancy.

    As a trans man or non-binary person, it’s safe to have an abortion with pills. If you are taking masculinizing hormones, misoprostol or mifepristone will not interfere. These abortion pills can be safely used if you are using testosterone (T) and/or gonadotrophin releasing hormone (GnRH) analogues. However, you might encounter difficulties finding inclusive abortion care. Learn more about abortion care in your country.

    References: “Abortion Explained! Queer & Trans Justice.” TWe Testify. https://www.wetestify.org/abortion-explained-queer-trans-justice “Drug interaction tool.” UpToDate. https://www.uptodate.com/login

Who Can Use Abortion Pills?

    No, use the same number of pills we recommend for everyone. Studies have shown that the success of the medication doesn’t decrease if you are overweight. You don’t need to take a different dose or more pills.

    You don’t need to change the dose or the number of pills if you find out you’re pregnant with twins. The same procedure is used for twin pregnancies

    No, each pregnancy is a unique event. If you used the abortion pills before, you don’t need a higher dose if you use it again for a different unwanted pregnancy.

    If you have an intrauterine contraceptive device in the uterus (e.g. the coil or the progesterone IUD), you must get it removed before your medical abortion.

    You can breastfeed as normal when having an abortion with pills. Mifepristone and misoprostol can enter the breast milk, but the amounts are small and it should not cause any side effects in the baby. If you are still nervous about it, you can breastfeed the baby, take the misoprostol pills, and wait 4 hours before you breastfeed again. If you need to take another round of misoprostol pills, breastfeed again before taking the pills. However, this is completely optional and up to your preference.

    If you are living with HIV, just make sure you’re on antiretroviral medicines and your health is good.

    If you have anemia (low iron levels in your blood), identify a health care provider who is no more than 30 minutes away that can help if you need it. If you are very anemic, consult a doctor before using the abortion pill.

    No, using abortion pills early in pregnancy is safe even if you had a previous C-section delivery.

    There has been no link found between mifepristone and birth defects. However, misoprostol does cause a slightly increased rate of birth defects. If you take misoprostol and you are still pregnant after taking the pills, you might have a natural miscarriage. If you do not have a miscarriage and carry the pregnancy to term, the risk of birth defects increases by 1% (one baby in 100).

    No, it is not safe to use abortion pills if you know that you are at risk for ectopic pregnancy. Because you had a tubal ligation, we know there is scarring in your tubes (Fallopian tubes). That’s probably why your last pregnancy was an ectopic pregnancy. The Fallopian tubes are where an egg is fertilized with a sperm. The pregnancy starts to grow and move along the tube to the womb. If your tube is scarred, the early pregnancy can get trapped in the tube. As the pregnancy grows, it can cause the tube to break open. If the tube breaks open, this can cause major bleeding inside you, which is life threatening. You are at risk for another ectopic pregnancy. You should not use the abortion pills on your own until you have an ultrasound and are sure that the pregnancy is in the womb, not in your tubes.

    First, you must know that you might not be aware of this condition unless you have had an ultrasound. Ectopic pregnancies are not viable so even in countries where abortion is not legal you could have access to a legal procedure to terminate this pregnancy.

    As a trans man or non-binary person, it’s safe to have an abortion with pills. If you are taking masculinizing hormones, misoprostol or mifepristone will not interfere. These abortion pills can be safely used if you are using testosterone (T) and/or gonadotrophin releasing hormone (GnRH) analogues. However, you might encounter difficulties finding inclusive abortion care. Learn more about abortion care in your country.

    References: “Abortion Explained! Queer & Trans Justice.” TWe Testify. https://www.wetestify.org/abortion-explained-queer-trans-justice “Drug interaction tool.” UpToDate. https://www.uptodate.com/login

Types of Abortion Pills and Their Use

    Research indicates that medical abortion is most often recommended for pregnancies prior to 13 weeks since your last menstrual period. The HowToUseAbortionPill protocol is also intended for pregnancies up to 13 weeks. Abortion pills can be used later in a pregnancy, but require different protocols and considerations for safety. For more information, you can reach out to our friends at www.womenonweb.org. Or go to our country profiles to learn more about abortion resources in your country.

    References:

    “Induced Abortion.” American College of Obstetrics and Gynecologists. https://www.acog.org/Patients/FAQs/Induced-Abortion “Care for Women Choosing Medication Abortion.” The Nurse Practitioner. https://journals.lww.com/tnpj/Citation/2004/10000/Care_for_Women_Choosing_Medication_Abortion.9.aspx
    “Safe abortion: technical and policy guidance for health systems.”The World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/70914/?sequence=1

    There are two types of abortion pills, and each has a different mechanism of action. Mifepristone blocks the hormone needed for a pregnancy to grow, while the ingredients used in misoprostol work by relaxing and opening the cervix (the opening to the uterus) and causing the uterus to contract, which pushes out the pregnancy.

    Misoprostol causes the uterus to contract and expel the pregnancy.

    Mifepristone blocks the hormone needed for a pregnancy to grow.

    Yes, you can use misoprostol safely at home. When you take misoprostol pills, try to make sure that you’re in an area (like your home) where you have privacy and can lay down for a few hours after you take the pills. Having someone with you who can look after you and bring you hot tea or something to eat can be very helpful.

    Do not eat or drink anything for 30 minutes while you allow the misoprostol to dissolve. After 30 minutes have passed, you can drink water to swallow the remnants of the pills and, in general, as much water as you need to feel hydrated.

    Yes, you can drink water to help you swallow the mifepristone.

    There are two ways to use misoprostol: placing the pills in your vagina or under your tongue (sublingually). HowToUseAbortionPill suggests that you only use misoprostol under your tongue because it is more private (the pills dissolve faster and do not leave visible traces in your body) and has less risk of infection.

    Both the combination of mifepristone and misoprostol and misoprostol-only are effective options. However, if available and affordable to you, the combination of mifepristone and misoprostol should be your preferred choice.

    98 women in 100 will have a complete abortion if mifepristone and misoprostol are used. About 95 women in 100 will have a complete abortion if only misoprostol is used.

    Mifepristone and misoprostol are used together because the pills complement each other. Mifepristone stops the pregnancy from growing. The medicine used in misoprostol works by relaxing and opening the cervix (the opening to the uterus) and causing the uterus to contract, which pushes out the pregnancy.

    If you use misoprostol pills under your tongue, no one will be able to tell you used abortion pills, as you will swallow everything after 30 minutes. If someone asks, you can say you had a natural miscarriage. If you use misoprostol vaginally, the coating of the pill may not dissolve completely for a day or two. If you need to seek urgent medical care within 48 hours since you used misoprostol vaginally, the healthcare provider may see the white coating of the pill in your vagina. This is why HowToUseAbortionPill suggests using misoprostol under your tongue and not inside your vagina.

Types of Abortion Pills and Their Use

    Research indicates that medical abortion is most often recommended for pregnancies prior to 13 weeks since your last menstrual period. The HowToUseAbortionPill protocol is also intended for pregnancies up to 13 weeks. Abortion pills can be used later in a pregnancy, but require different protocols and considerations for safety. For more information, you can reach out to our friends at www.womenonweb.org. Or go to our country profiles to learn more about abortion resources in your country.

    References:

    “Induced Abortion.” American College of Obstetrics and Gynecologists. https://www.acog.org/Patients/FAQs/Induced-Abortion “Care for Women Choosing Medication Abortion.” The Nurse Practitioner. https://journals.lww.com/tnpj/Citation/2004/10000/Care_for_Women_Choosing_Medication_Abortion.9.aspx
    “Safe abortion: technical and policy guidance for health systems.”The World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/70914/?sequence=1

    There are two types of abortion pills, and each has a different mechanism of action. Mifepristone blocks the hormone needed for a pregnancy to grow, while the ingredients used in misoprostol work by relaxing and opening the cervix (the opening to the uterus) and causing the uterus to contract, which pushes out the pregnancy.

    Misoprostol causes the uterus to contract and expel the pregnancy.

    Mifepristone blocks the hormone needed for a pregnancy to grow.

    Yes, you can use misoprostol safely at home. When you take misoprostol pills, try to make sure that you’re in an area (like your home) where you have privacy and can lay down for a few hours after you take the pills. Having someone with you who can look after you and bring you hot tea or something to eat can be very helpful.

    Do not eat or drink anything for 30 minutes while you allow the misoprostol to dissolve. After 30 minutes have passed, you can drink water to swallow the remnants of the pills and, in general, as much water as you need to feel hydrated.

    Yes, you can drink water to help you swallow the mifepristone.

    There are two ways to use misoprostol: placing the pills in your vagina or under your tongue (sublingually). HowToUseAbortionPill suggests that you only use misoprostol under your tongue because it is more private (the pills dissolve faster and do not leave visible traces in your body) and has less risk of infection.

    Both the combination of mifepristone and misoprostol and misoprostol-only are effective options. However, if available and affordable to you, the combination of mifepristone and misoprostol should be your preferred choice.

    98 women in 100 will have a complete abortion if mifepristone and misoprostol are used. About 95 women in 100 will have a complete abortion if only misoprostol is used.

    Mifepristone and misoprostol are used together because the pills complement each other. Mifepristone stops the pregnancy from growing. The medicine used in misoprostol works by relaxing and opening the cervix (the opening to the uterus) and causing the uterus to contract, which pushes out the pregnancy.

    If you use misoprostol pills under your tongue, no one will be able to tell you used abortion pills, as you will swallow everything after 30 minutes. If someone asks, you can say you had a natural miscarriage. If you use misoprostol vaginally, the coating of the pill may not dissolve completely for a day or two. If you need to seek urgent medical care within 48 hours since you used misoprostol vaginally, the healthcare provider may see the white coating of the pill in your vagina. This is why HowToUseAbortionPill suggests using misoprostol under your tongue and not inside your vagina.

Abortion Pill Contraindications

    You should avoid using abortion pills at home following the HowToUseAbortionPill protocol if you are more than 12 weeks pregnant; if you are allergic to mifepristone or misoprostol; if you have serious health problems, including blood-clotting problems; or if you believe or know that the pregnancy is growing outside the womb (ectopic pregnancy).

Abortion Pill Contraindications

    You should avoid using abortion pills at home following the HowToUseAbortionPill protocol if you are more than 12 weeks pregnant; if you are allergic to mifepristone or misoprostol; if you have serious health problems, including blood-clotting problems; or if you believe or know that the pregnancy is growing outside the womb (ectopic pregnancy).

Side Effects and Complications of Abortion Pills

    For some, cramping is very strong – much more painful than menstrual cramps (if you have menstrual cramps) and the bleeding is much heavier than a menstrual period. You might pass blood clots up to the size of lemons in the first few hours after taking misoprostol. For others, cramping is mild and bleeding is like a normal menstrual period.

    Seek medical care if you don’t bleed or have little bleeding followed by severe pain (particularly in the right shoulder) that is not relieved by ibuprofen. This can be a sign of an ectopic pregnancy (a pregnancy that is located outside of the uterus). While this is rare, it can be life threatening. You can also contact our friends at www.safe2choose.org to speak to a trained abortion counselor if you are concerned that the abortion was not successful.

    Seek medical care if you soak through 2 regular pads per hour for 2 hours in a row after you think you have passed the pregnancy. Soaking through means that the pad is saturated with blood front-to-back, side-to-side, and through-and-through.

    Take 3-4 ibuprofen pills (200 mg) every 6-8 hours to help alleviate your pain. Remember that you can also take ibuprofen before using misoprostol, too.

    After the misoprostol has dissolved, you can eat as you like. Dry food (e.g. crackers or toast) may help with the nausea, while green leafy vegetables, eggs, and red meat can help recover the minerals lost during the abortion.

    After the misoprostol has dissolved, you can drink any liquid you like (except alcohol).

    Alcohol should be avoided during the abortion process to avoid affecting the efficiency of the medication. Alcohol may also cause increased uterine bleeding in some cases and decrease the effectiveness of other medicines taken to reduce pain or infection (when dealing with complications). In general, it is recommended to avoid alcohol until you confirm the abortion is complete and you are feeling in good health.

    Most will pass the pregnancy within about 4 – 5 hours and feel better in less than 24 hours. It is normal to continue to see light bleeding and spotting until your next period in about 3 – 4 weeks.

    It is normal to feel sick to your stomach, have diarrhea, chills, or even feel like you have a fever during this time. Most report they know when they have passed the pregnancy because the bleeding slows down, and they start to feel much better.

    You might need to have a surgical procedure if you’re still pregnant after taking the pills. Remember! Treatment for an incomplete abortion is widely available around the world. You have the right to this service, even if abortion is legally restricted in your country.

Side Effects and Complications of Abortion Pills

    For some, cramping is very strong – much more painful than menstrual cramps (if you have menstrual cramps) and the bleeding is much heavier than a menstrual period. You might pass blood clots up to the size of lemons in the first few hours after taking misoprostol. For others, cramping is mild and bleeding is like a normal menstrual period.

    Seek medical care if you don’t bleed or have little bleeding followed by severe pain (particularly in the right shoulder) that is not relieved by ibuprofen. This can be a sign of an ectopic pregnancy (a pregnancy that is located outside of the uterus). While this is rare, it can be life threatening. You can also contact our friends at www.safe2choose.org to speak to a trained abortion counselor if you are concerned that the abortion was not successful.

    Seek medical care if you soak through 2 regular pads per hour for 2 hours in a row after you think you have passed the pregnancy. Soaking through means that the pad is saturated with blood front-to-back, side-to-side, and through-and-through.

    Take 3-4 ibuprofen pills (200 mg) every 6-8 hours to help alleviate your pain. Remember that you can also take ibuprofen before using misoprostol, too.

    After the misoprostol has dissolved, you can eat as you like. Dry food (e.g. crackers or toast) may help with the nausea, while green leafy vegetables, eggs, and red meat can help recover the minerals lost during the abortion.

    After the misoprostol has dissolved, you can drink any liquid you like (except alcohol).

    Alcohol should be avoided during the abortion process to avoid affecting the efficiency of the medication. Alcohol may also cause increased uterine bleeding in some cases and decrease the effectiveness of other medicines taken to reduce pain or infection (when dealing with complications). In general, it is recommended to avoid alcohol until you confirm the abortion is complete and you are feeling in good health.

    Most will pass the pregnancy within about 4 – 5 hours and feel better in less than 24 hours. It is normal to continue to see light bleeding and spotting until your next period in about 3 – 4 weeks.

    It is normal to feel sick to your stomach, have diarrhea, chills, or even feel like you have a fever during this time. Most report they know when they have passed the pregnancy because the bleeding slows down, and they start to feel much better.

    You might need to have a surgical procedure if you’re still pregnant after taking the pills. Remember! Treatment for an incomplete abortion is widely available around the world. You have the right to this service, even if abortion is legally restricted in your country.

Medical Abortion and Future Fertility

    You can get pregnant again as soon as 8 days after a medical abortion. If you have sex, you should consider using contraceptives to prevent an unplanned pregnancy.

    No, abortion pills do not cause birth defects in future pregnancies.

    No, having an abortion with pills will not make it harder to get pregnant in the future.

Medical Abortion and Future Fertility

    You can get pregnant again as soon as 8 days after a medical abortion. If you have sex, you should consider using contraceptives to prevent an unplanned pregnancy.

    No, abortion pills do not cause birth defects in future pregnancies.

    No, having an abortion with pills will not make it harder to get pregnant in the future.

Other Abortion FAQs

    Abortion methods should not be confused with methods to prevent pregnancy (contraceptive methods, including emergency contraception). Contraceptive methods work by preventing ovulation (the release of an egg) or by stopping the egg and sperm from meeting. Contraceptive methods, including emergency contraception, cannot be used to terminate or interrupt an established pregnancy. You can visit www.findmymethod.org to learn more about contraceptive methods.

    Emergency contraceptive pills (ECPs) are a safe and effective means of preventing pregnancy after unprotected sexual intercourse. They work by preventing ovulation (the release of an egg) or by stopping the egg and sperm from meeting. ECPs will not terminate or interrupt an established pregnancy. ECPs are different from medical abortion regimens (which include mifepristone and misoprostol). Both treatments are of critical importance for reproductive health globally.

    There are two common types of abortion methods: 1) Medical abortion: Medical abortions use pharmacological drugs to terminate the pregnancy. Sometimes the terms “non-surgical abortion” or “abortion with pills” are also used.

    2) Surgical abortion: In surgical abortion procedures, a qualified professional will empty the uterus through the cervix to terminate the pregnancy. These procedures include manual vacuum aspiration (MVA) and dilatation and evacuation (D&E).

Other Abortion FAQs

    Abortion methods should not be confused with methods to prevent pregnancy (contraceptive methods, including emergency contraception). Contraceptive methods work by preventing ovulation (the release of an egg) or by stopping the egg and sperm from meeting. Contraceptive methods, including emergency contraception, cannot be used to terminate or interrupt an established pregnancy. You can visit www.findmymethod.org to learn more about contraceptive methods.

    Emergency contraceptive pills (ECPs) are a safe and effective means of preventing pregnancy after unprotected sexual intercourse. They work by preventing ovulation (the release of an egg) or by stopping the egg and sperm from meeting. ECPs will not terminate or interrupt an established pregnancy. ECPs are different from medical abortion regimens (which include mifepristone and misoprostol). Both treatments are of critical importance for reproductive health globally.

    There are two common types of abortion methods: 1) Medical abortion: Medical abortions use pharmacological drugs to terminate the pregnancy. Sometimes the terms “non-surgical abortion” or “abortion with pills” are also used.

    2) Surgical abortion: In surgical abortion procedures, a qualified professional will empty the uterus through the cervix to terminate the pregnancy. These procedures include manual vacuum aspiration (MVA) and dilatation and evacuation (D&E).

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