How To Use The Pill

There are two options for medical abortion. Both ways are very effective:

Instructions For Abortion With Mifepristone and Misoprostol

Before starting, read over our advice on Before Using The Pill. Be sure:

  • Your pregnancy is within the first 11 weeks (77 days)
  • You've reviewed all of our considerations and general advice
  • You have a safety plan in case of emergency
Step 1:
Swallow one mifepristone (200 mg) with water.
Step 2:
Wait 24-48 hours. You should wait 24 hours before using the misoprostol, but wait no longer than 48 hours. While you wait, just do the things you normally do in your everyday life, like taking care of your family or going to work or school.
Step 3:
Place 4 misoprostol pills (200 mcg each) under your tongue. Hold them under your tongue for 30 minutes. They may make your mouth dry or taste chalky as they dissolve. Do not eat or drink anything for these 30 minutes. After 30 minutes, rinse your mouth with water and drink down everything that is left of the pills.
If you vomit during the 30 minutes that the misoprostol pills are under your tongue, it is likely they will not work. In this case, it is necessary to immediately repeat step 3. If you vomit after the pills have been under your tongue for 30 minutes, there is no need to repeat that step, as the pills have already absorbed into your system.
You should begin bleeding within 3 hours after using the 4 misoprostol pills. The bleeding should be similar to or heavier than your normal menstrual period. This is a sign that the abortion is working.
After waiting 3 hours, all women between 9-11 weeks pregnant should proceed to Step 4. If you are under 9 weeks pregnant and have had little or no bleeding after completing Step 3, proceed to Step 4. If you are under 9 weeks pregnant and have had period-like bleeding (or more) after Steps 1-3, you do not need to continue to the next step as the process is likely complete.
Step 4:
If you are 9-11 weeks pregnant OR had little or no bleeding 3 hours after Step 3, place 4 pills of misoprostol (200 mcg each) under your tongue. Hold them under your tongue for 30 minutes. After 30 minutes, rinse your mouth with water and drink down everything that is left of the pills.
If 3 hours pass and you still have no or little bleeding, contact our friends at www.safe2choose.org, www.womenhelp.org or www.womenonweb.org for support. We do not recommend using any more pills until the situation can be evaluated by a trained support person.

Other Considerations For An Abortion With Mifepristone And Misoprostol:

Learn what to expect after taking mifepristone + misoprostol here.

If you experience bad cramping, ibuprofen is a good medicine to cope with pain. You can buy ibuprofen 200 mg strength over the counter (without a prescription) in most countries. Take 3-4 pills (200 mg each) every 6-8 hours. If you need something extra for pain relief, you can also use 2 pills of Tylenol (325 mg) every 6-8 hours.

If you used the abortion pills mifepristone and misoprostol, you probably do not need to visit a health care provider for a follow-up visit. These medicines are so effective that the World Health Organization recommends that you need to have a follow-up only if:

  • You feel sick, or your pain is not getting better after 2 or 3 days. If this occurs, seek medical attention right away.
  • You still feel pregnancy symptoms two weeks after taking the abortion pills.
  • Your bleeding is heavy and not getting lighter after 2 weeks.

Instructions For Abortion With Misoprostol Only

Before starting, read over our advice on Before Using The Pill. Be sure:

  • Your pregnancy is within the first 11 weeks (77 days)
  • You've reviewed all of our considerations and general advice
  • You have a safety plan in case of emergency
Step 1:
Place 4 misoprostol pills (200 mcg each) under your tongue. Hold them under your tongue for 30 minutes. They may make your mouth dry or taste chalky as they dissolve. Do not eat or drink anything for these 30 minutes. After 30 minutes, rinse your mouth with water and drink down everything that is left of the pills. Wait 4 hours before proceeding to Step 2.
If you vomit during the 30 minutes that the misoprostol pills are under your tongue, it is likely they will not work. In this case, it is necessary to immediately repeat step 1. If you vomit after the pills have been under your tongue for 30 minutes, there is no need to repeat that step, as the pills have already absorbed into your system.
Bleeding should begin within 3-4 hours of using misoprostol pills. The bleeding should be similar to or heavier than your normal menstrual period. This is a sign that the abortion is working.
Step 2:
Repeat step 1 with another 4 pills, wait 3 hours.
All women between 9-11 weeks pregnant should proceed to Step 3. If you are under 9 weeks pregnant and have had little or no bleeding after completing Step 2, proceed to Step 3. If you are under 9 weeks pregnant and have had period-like bleeding (or more) after Steps 1-2, you do not need to continue to the next step as the process is likely complete.
Step 3 (Only if you are 9-11 weeks pregnant, or had little or no bleeding after Steps 1-2):
Repeat step 1 with another 4 pills.
If you have used all 12 pills and experience no or very little bleeding or cramping, contact our friends at www.safe2choose.org, www.womenhelp.org or www.womenonweb.org for support. We do not recommend using any more pills until the situation can be evaluated by a trained support person.

Other Considerations For An Abortion With Misoprostol:

Learn what to expect after taking misoprostol here.

If you experience bad cramping, ibuprofen is a good medicine to cope with pain. You can buy ibuprofen 200 mg strength over the counter (without a prescription) in most countries. Take 3-4 pills (200 mg each) every 6-8 hours. If you need something extra for pain relief, you can also use 2 pills of Tylenol (325 mg) every 6-8 hours.

If you used misoprostol, you probably do not need to visit a health care provider for a follow-up visit. These medicines are so effective that the World Health Organization recommends that you need to have a follow-up only if:

  • You feel sick, or your pain is not getting better after 2 or 3 days. If this occurs, seek medical attention right away.
  • You still feel pregnancy symptoms two weeks after taking the abortion pills.
  • Your bleeding is heavy and not getting lighter after 2 weeks.

Authors:

All content featured on this website is written by the HowToUseAbortionPill.org team in compliance with standards and protocols from The National Abortion Federation, Ipas, the World Health Organization, DKT International and carafem.

The National Abortion Federation (NAF) is the professional association of abortion providers in North America, and a leader in the pro-choice movement. Content on HowToUseAbortionPill.org is aligned with the 2020 Clinical Policy Guidelines released by NAF.

Ipas is the only international organization solely focused on expanding access to safe abortion and contraceptive care. Content on HowToUseAbortionPill.org is aligned with the Clinical Updates In Reproductive Health 2019 released by Ipas.

The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. Content on HowToUseAbortionPill.org is aligned with the 2012 Safe abortion: technical and policy guidance for health systems released by WHO.

DKT International is a registered, non-profit organization founded in 1989 to focus the power of social marketing on some of the largest countries with the greatest needs for family planning, HIV/AIDS prevention and safe abortion.

carafem is a clinic network providing convenient and professional abortion care and family planning so people can control the number and spacing of their children.

References:

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