How to Use the Abortion Pill

Before you start, read our article: Before Using the Pill. Before taking the pills, make sure:

• you are less than 13 weeks pregnant (91 days);
• you’ve reviewed all our considerations and general advice; and
• you have a safety plan ready in the rare case of an emergency.

How do I use mifepristone and misoprostol for an abortion?

For an abortion with mifepristone and misoprostol, you will need to take one 200 mg mifepristone pill and at least four 200 mcg misoprostol pills (totaling 800 mcg).

It’s better to take eight misoprostol pills in total. You might need to take all of them to make sure the abortion is complete, especially if you are 9–13 weeks pregnant. However, if you only have four misoprostol pills, it’s okay.

Painkillers (like ibuprofen) and anti-nausea medicine can also help you during an abortion. If you are feeling very nauseous, we recommend you take anti-nausea medication 30 minutes before taking mifepristone or misoprostol, to prevent vomiting.

You do not need to fast during an abortion with pills. You can eat and drink as you usually do, except for when the pills are under your tongue.

Here’s how mifepristone and misoprostol are taken together to end a pregnancy:

Step 1: How do I take mifepristone?

Take one 200 mg mifepristone pill with water.

If you vomit within the first hour of taking the mifepristone, it may not work and you’ll need to take an extra pill. If you vomit after the first hour, you don’t need to worry.

Step 2: How long do I wait after taking mifepristone?

Wait 24–48 hours.

Mifepristone does not usually have side effects, so you can go about your life as normal. Rarely, some people experience bleeding before the misoprostol. If this happens, it is okay; proceed as usual.

You can move on to the next step any time between 24h and 48h later, so you can choose the most convenient time to start. Once you start taking the misoprostol, make sure you are somewhere you feel safe and comfortable for at least 12 hours, but ideally 24 hours. If possible, we recommend initiating the administration of misoprostol in the morning. This allows you to monitor your body’s response throughout the day and ensures you have the night available for adequate rest.

Step 3: Take painkillers before misoprostol

Start by taking a pain reliever like ibuprofen (800 mg) about 30 minutes before using misoprostol because cramping will start soon after you take the pills. If you have anti-nausea medication, take it with the pain reliever.

Next, place four misoprostol pills (200 mcg each) under your tongue and hold them there for 30 minutes. You can swallow your saliva, but you should not speak or eat for the 30 minutes; therefore, it is best to take them someplace quiet where you will not be disturbed. After 30 minutes, drink some water and swallow everything that is left of the pills.

If you vomit within the first 30 minutes of taking the misoprostol, repeat Step 3. If you vomit after that time, there is no need to repeat anything because the medicine will already have been absorbed by your body.

Cramping and bleeding can start as soon as 30 minutes after taking misoprostol, but it might take up to 24 hours to begin. Most people start bleeding within about four to six hours after taking it.

You can continue to take three to four ibuprofen pills (200 mg each) every six to eight hours to manage the pain, if needed. Do not exceed 3200 mg in 24 hours, and do not use regular aspirin as it increases your risk of bleeding. Acetaminophen or paracetamol (1000 mg) can also be used if you are allergic to NSAIDs, but they may not work as well as ibuprofen.

Step 4: When do I need a second dose of misoprostol?

If you are less than nine weeks pregnant, you probably won’t need a second dose. But if you haven’t bled as much as you would with a menstrual period within 24 hours, or if you’re worried your bleeding is too light, you can take four more misoprostol pills the same way as before.

If you are 9–13 weeks pregnant, it’s a good idea to take four more misoprostol pills the same way you took the first dose, four hours after the first dose. This makes the pills work better and is more likely to result in a successful abortion.

How do I use misoprostol alone for an abortion?

Before you start, read our article: Before Using the Pill. Before taking the pills, make sure:

• you are less than 13 weeks pregnant (91 days);
• you’ve reviewed all our considerations and general advice; and
• you have a safety plan ready in the rare case of an emergency.

If mifepristone is not available where you are, you can use misoprostol alone to end a pregnancy.

For an abortion with only misoprostol, you will need to take 12 200 mcg misoprostol pills.

Taking 12 misoprostol pills may help to achieve a successful abortion, particularly if your pregnancy is between 9–13 weeks. If your pregnancy is under nine weeks and you don’t have access to 12 misoprostol pills, you can use 8 pills, but the effectiveness rate will be reduced.

Pain (ibuprofen) and anti-nausea medicine can also help during an abortion. If you are feeling very nauseous, we recommend you take anti-nausea medication 30 minutes before taking misoprostol to prevent vomiting.

You do not need to fast during an abortion with pills. You can eat and drink as usual, except for when you have the pills under your tongue.

Here’s how misoprostol alone is used to end a pregnancy:

Step 1: How do I take the first dose of misoprostol?

Start by taking a pain reliever like ibuprofen (800 mg) about 30 minutes before using misoprostol because cramping will start soon after. If you have anti-nausea medication, take it now.

Next, place four misoprostol pills (200 mcg each) under your tongue and keep them there for 30 minutes. You can swallow your saliva, but you should not speak or eat for these 30 minutes, so it’s best to be someplace quiet where you will not be disturbed. After 30 minutes, drink some water and swallow everything that is left of the pills.

If you vomit within the first 30 minutes of taking the misoprostol, repeat Step 1. If you vomit after that time, there is no need to repeat the process because the medicine would have already been absorbed by your body.

Cramping and bleeding can start as soon as 30 minutes after taking misoprostol, but it might take up to 24 hours to begin. Most people bleed within about four to six hours of taking misoprostol.

You can continue to take three to four ibuprofen pills (200 mg each) every six to eight hours to manage the pain, if needed. Do not exceed 3200 mg in 24 hours, and do not use regular aspirin as it increases your risk of bleeding. Acetaminophen or paracetamol (1000 mg) can also be used if you are allergic to NSAIDs; however, they may not work as well as ibuprofen.

Step 2: How long should I wait between misoprostol doses?

Wait three hours.

Step 3: How do I take the second dose of misoprostol?

Place another four misoprostol pills (200 mcg each) under your tongue and hold them there for 30 minutes.

Step 4:

Wait another three hours.

Step 5: How do I take the third dose of misoprostol?

Place another four misoprostol pills (200 mcg each) under your tongue and hold them there for 30 minutes.

What should I expect after taking all misoprostol doses?

You should begin bleeding and cramping while taking the pills. Make sure to take all 12 pills, even if you start to bleed before you’ve taken all of them.