Abortion Questions – Abortion Pill FAQs

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 pill instructions are the same for a twin pregnancy as a single pregnancy.

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 copper IUD or the progesterone IUD) it is highly recommended to have it removed prior to taking abortion pills.

You can breastfeed as normal when having an abortion with pills. Mifepristone and misoprostol enter the breastmilk in very small amounts, and these amounts are too small to cause any side effects or harm to your infant. Breastfeeding can continue without interruption during an abortion with pills.

If you are living with HIV, you can have an abortion with pills the same as anyone else. It is always advised to be on antiretroviral medicines for best health.

If you have anemia (low iron in your blood), you can still undergo an abortion with pills, but it is best to identify an accessible health care provider that can help if you need it. If you have severe anemia it is best to consult a clinician prior to using the pills.

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 fetal malformation related to misoprostol exposure is still less than 10 per 1,000 exposures.

If you had a previous sterilization procedure and are now pregnant, you can still use the abortion pills. However, you are at a higher risk than the average person for an ectopic pregnancy, or pregnancy outside the uterus, because the previous sterilization creates scarring in the fallopian tubes. You can choose to proceed with the abortion pills, however if you do have an ectopic pregnancy the pills will not work. They will not cause harm, but your ectopic pregnancy will continue to grow and can cause a potentially life threatening situation. If it is an ectopic pregnancy it will require special medical attention and treatment. If you had a previous sterilization procedure and had an ultrasound to confirm the pregnancy is within the uterus (not ectopic) it is safe to use the pills.

If you had a previous ectopic pregnancy that was treated, and you are now pregnant again, you can still use the abortion pills. However you are at a higher risk than the average person for another ectopic pregnancy. You can choose to proceed with the abortion pills, however if you do have an ectopic pregnancy the pills will not work. They will not cause harm, but your ectopic pregnancy will continue to grow and can cause a potentially life threatening situation. If it is another ectopic pregnancy it will require special medical attention and treatment. If you had a previous ectopic pregnancy and had an ultrasound to confirm the current pregnancy is within the uterus (not ectopic) it is safe to use the pills.

Ectopic pregnancies are diagnosed with ultrasound. If you have been diagnosed with an ectopic pregnancy it is not recommended to use the abortion pills as they will not work. Instead you must seek medical care for treatment of the ectopic pregnancy as this is not a viable pregnancy. 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.

In most countries, a prescription is required to purchase abortion pills. However, it varies from country to country. Check our Country Profiles page to find local organizations that can help you.

In most countries, an adult has to purchase the abortion pills. However, it varies from country to country. Visit our Country Profiles page to find organizations that can help you.

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.

An abortion with pills is extremely safe and effective when used properly. An abortion with mifepristone and misoprostol works successfully over 95% of the time, and the chance of a complication is less than 1% up to 10 weeks gestation and 3% between 10 and 13 weeks gestation. When using misoprostol alone, the abortion has a success rate of 80-85%, and a chance of complication of 1-4% up to 13 weeks gestation. According to the World Health Organization, an abortion with pills can be safely and effectively self-administered at home as long as you have access to accurate information and quality-assured medicines.

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 safely use misoprostol at home. When you take the misoprostol pills, try to make sure that you’re in a space (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.

You can find out more by visiting our Medical Abortion page.

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 three ways to successfully use misoprostol: placing the pills in your vagina (vaginally), under your tongue (sublingually), or between the gum and cheek (buccally).

HowToUseAbortionPill suggests that you only use misoprostol under your tongue because it’s easier, the pills dissolve quickly, and it is more private as no visible traces are left in your body. If you need to seek medical help after an abortion, there is no way for health-care professionals to find traces of the medication in your body, and you can say that you had a miscarriage.

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 as it is slightly more effective than misoprostol alone.

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.

If you have an allergy to NSAIDs (including ibuprofen), acetaminophen (Tylenol/Paracetamol) is recommended as an alternative pain medication. It’s available over-the-counter in most countries. Take 2 tablets (325 mg tablets) every 4-6 hours as needed for pain. The maximum dose in 24 hours is 4000mg.

Avoid using anti-spasmodics (like Buscopan), as they can slow the abortion process by relaxing the uterus, and regular aspirin, as it can cause increased bleeding.

You can take misoprostol at least 24 hours, but no more than 48 hours, after taking mifepristone. So, you will have to wait at least 24 hours after taking mifepristone. You can choose a time that works best for you within this time frame.

You can take mifepristone and misoprostol whenever is most convenient for you, but we recommend that you plan to take it in the morning. This way, you can monitor the process during the day and have the night to rest.

Learn more about what to expect during an abortion with pills in our After Abortion Pills section.

You always calculate this interval from the time you place the misoprostol pills under your tongue.

If you are only using misoprostol, the interval between doses will be three hours. That is, if you place the pills under your tongue at 12 pm, you should place the next dose under your tongue at 3 pm.

If you are using mifepristone and misoprostol and you need to take a second dose, the interval between doses will be four hours. In that case, if you place the misoprostol pills under your tongue at 12 pm, you should take the next dose at 4 pm.

Learn more about how to use abortion pills.

You should avoid using pills that are not pure misoprostol. If you only have access to misoprostol that contains diclofenac (such as Rotec or Arthrotec), you should not swallow the pills as they contain a very high dose of painkiller and it can be harmful. Instead, just place it under your tongue and spit out the remains after 30 minutes.

Yes, you can sleep and rest during the process; it might help you feel more comfortable.

You can do whatever makes you feel more comfortable. You don’t need to rest during the abortion, but it’s okay if you need to – listen to your body.

If you are a smoker, you can smoke as usual.

Marijuana will not hinder the process and may even help with the pain. However, it’s best to avoid anything that alters your consciousness as it could disrupt your perception and distract you from possible signs of complications. So, it might be best not to smoke marijuana during the abortion process.

It’s good to do a urine or blood pregnancy test four to five weeks after your abortion, to make sure it worked. Testing earlier may give a false positive.

Either way, listen to your body. If you continue to have pregnancy symptoms (breast tenderness, nausea, fatigue, etc.) after using the pills, go for an ultrasound to check whether the abortion was successful.

You will need one 200 mg (milligrams) mifepristone pill and four or eight 200 mcg (micrograms) misoprostol pills.

These are the most common doses for mifepristone and misoprostol. But if the pills you have have different amounts of milligrams (mg) or micrograms (mcg), you’ll need to calculate how many pills to take to get the right amount of medicine.

Learn more about how to use abortion pills.

You may not pass visible pregnancy tissue if your pregnancy is less than seven weeks. Early on, the gestational sac is small (about 1 cm) and hard to recognize. Between 10-13 weeks, it’s larger (2–8 cm), so you might see or feel a recognizable embryo or fetus when it passes. You don’t need to worry about identifying anything. If you feel something more consistent coming out, just sit on the toilet and try to relax.

Remember, diarrhea is a very common side effect of abortion pills, and it can make identifying tissue harder. The gestational sac is firm, unlike clots, and won’t dissolve in water. Once it’s passed, you’re no longer pregnant, but your body may continue to discharge tissue over the next few days.

You can read more about what to expect in our After Abortion Pills section.

You might have read somewhere that you need to fast or exercise during an abortion with pills – this is not true. Except for the time when you have the misoprostol pills under your tongue, you can eat and drink as usual. Besides that, we recommend that you stay as comfortable as possible until you feel better.

You should avoid using abortion pills at home following the HowToUseAbortionPill protocol if you are more than 13 weeks (91 days) 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).

While overdose is extremely unlikely, excessive misoprostol doses can lead to significant side effects of fevers, chills, increased heart rate, abdominal pain, diarrhea, and others. It is important to follow the recommended dosage: 4 pills (200mcg each) every 3-4 hours.

When misoprostol is used alone, abortion usually occurs after the second or third dose of 4 misoprostol pills. When used with mifepristone, abortion often occurs after a single dose of 4 misoprostol pills. It is recommended to redose the misoprostol every 3-4 hours until expulsion, however if you have already used 5 doses it may be a sign that it is not working and seeking medical advice would be recommended.

Learn more about how to use abortion pills on our How To Use the Abortion Pills section.

Every abortion experience is different. You might experience more cramping and bleeding than during a normal menstrual period (if you have menstrual cramps). But it’s also normal if your cramping is mild and your bleeding is like a normal menstrual period. Other common side effects are nausea, diarrhea, fever, and headaches. However, you should feel better in less than 24 hours. If you start to feel sicker, then you should seek medical attention.

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. Bleeding is generally the heaviest within the first 24 hours of using misoprostol.

In order for a pill abortion to work, you must experience bleeding. 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.

Cramping usually begins about 30 minutes after taking misoprostol and can last four to eight hours. It’s a sign your uterus is contracting to expel the pregnancy. The pain can vary from mild to intense.

Pain relief is very important. Medications like ibuprofen (400-800 mg every six to eight hours) or diclofenac (50 mg every 12 hours) can work well. Acetaminophen or paracetamol alone do not work well enough for pain during an abortion, so they are not recommended unless you have an allergy to ibuprofen. However, you can alternate with ibuprofen if extra relief is needed.

Avoid using anti-spasmodics (like Buscopan), as they can slow the abortion process by relaxing the uterus, and regular aspirin, as it can cause increased bleeding.

In addition, resting in a comfortable place and using a heating pad, drinking hot tea, and having a hot shower can all help ease cramping.

After the misoprostol has dissolved for 30 minutes, you can eat as you like. There are no restrictions on the types of food that you can eat. HowToUseAbortionPill suggests simple, dry foods (e.g. crackers or toast) as they may help with the nausea, while green leafy vegetables, eggs, and red meat can provide protein and help recover the minerals lost during the abortion.

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

HowToUseAbortionPill recommends avoiding alcohol during the pill abortion process to minimize negative effects of the alcohol on the medications and with your ability to care for yourself. Alcohol also has the potential to impact the bleeding. Once you are feeling confident that the abortion was successful it is okay to consume alcohol.

Most will pass the pregnancy and experience the worst cramping and bleeding symptoms within about 4 – 5 hours of using the first dose of misoprostol. Most people will begin feeling better within 24 hours after after using the last dose of misoprostol. It is normal to continue to see light bleeding and spotting until your next period in about 3 – 4 weeks.

After using misoprostol, 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, side effects of the medication decrease, and pregnancy symptoms begin to decrease.

Complications in a medical abortion are very rare. However, it’s important that you are able to recognize possible signs of complication. If you experience heavy bleeding (soaking 2 regular pads per hour for 2 hours in a row), have extreme pain that does not get better after taking ibuprofen or start to feel sicker any day after you use misoprostol, you should seek medical attention.

Are medical abortions or at-home abortions legally restricted in your country? You may need to be careful about what you say. Medical abortion has the same symptoms as a natural miscarriage (also known as a spontaneous abortion). Therefore, you can say things like “I’m bleeding, but it doesn’t feel like my normal period.”

There are different ways to know if an abortion was successful. During the abortion, you might be able to identify that you passed the pregnancy tissue (this might look like small dark coloured grapes and thin membranes, or a small sac surrounded by a white, fluffy layer). This is an indication that the abortion was successful. However, it might not always be possible to identify the pregnancy tissue. Another indication of a successful abortion is disappearing pregnancy symptoms, such as breast tenderness and nausea. A home pregnancy test is another way to confirm the success of an abortion. However, be aware that a pregnancy test might be positive for 4 weeks after your abortion, due to lingering hormones in your body. An ultrasound is only necessary if there are doubts whether the pregnancy was successfully terminated or if there is suspicion of complications (heavy bleeding or an infection).

An ultrasound is not required after an abortion with pills. An ultrasound is only necessary if there is suspicion of complications (heavy bleeding or infection) or if there are doubts whether the pregnancy was terminated. If you continue to feel pregnancy symptoms (have breast tenderness, nausea, fatigue, etc.) after using the pills, you will need to consult with a healthcare worker for next steps. A possible next step could be to have an ultrasound, if deemed appropriate. 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 in your country.

If you did not experience bleeding or cramping with the pills and suspect you are still pregnant, or if you confirm with an ultrasound your pregnancy is still growing, you can repeat the HowToUseAbortionPill procedure up to 13 weeks of pregnancy.

If you confirm your pregnancy has stopped growing with an ultrasound, but the pregnancy has not expelled from the uterus, it is an incomplete abortion (similar to a miscarriage) and you are eligible to have a surgical procedure to remove the pregnancy. This is widely available around the world because your pregnancy is no longer considered viable. Alternatively, it is safe to repeat the pill abortion process which is likely to be successful in expelling the pregnancy a second time.

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

Learn more about what to expect during an abortion with pills in our After Abortion Pills section.

Diarrhea is a common side effect of misoprostol, and although it’s uncomfortable, it’s not a sign of a complication. It should disappear within the first 24 hours. It’s important to drink plenty of water and stay nourished – you can eat anything you like.

A rise in temperature is normal after taking misoprostol. You should only be concerned if you have a fever of 38°C (100.4°F) that does not decrease after taking ibuprofen or that does not decrease 24 hours after using misoprostol. Always confirm with a thermometer.

If you have redness, itchiness, or a swollen neck or face, or swollen hands, you might be having an allergic reaction to the medication. In this case, you can take an anti-allergy medicine or antihistamine. However, if you have difficulty breathing, it means the allergy is very serious and you need immediate medical help.

It is normal for some fluid to come out of your breasts for a few days after an abortion. You don’t need to worry as long as there is no pain, redness, swelling, or fever. If you experience any of these symptoms, seek medical help.

You can get pregnant again as soon as 8 days after a medical abortion. If you have sex and do not want to be pregnant, you should consider using a contraceptive method 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.

Although abortion is common, we can find it hard to talk about. Abortion is still surrounded by misinformation, myths, and stigma. When you talk about abortion, try to use accurate information from reliable sources, avoid stigmatizing language and be inclusive in your language – a diversity of people have abortions. Although it may not always be easy, don’t start a debate. Instead, ask open-ended questions about people’s attitudes and experiences with abortion.

The legal status of an abortion with pills depends on where you live. In some countries, abortion is legal up until a certain amount of weeks of gestation, while in other countries abortion is legal under certain circumstances (for example, in case of rape or danger to the life of the pregnant person). Abortion pills are often legally available in countries where abortion is legal, although they may not always be used outside of a health facility. There are also countries where abortion is completely prohibited. Learn more about abortion in your country.

Everyone’s abortion experience feels different. Some feel relief and happiness, while others experience sadness. All emotions are normal. However, lasting negative feelings are rare. What can negatively impact your mental health is encountering stigma and judgment. Remember that you are not alone – abortion is common. Support from friends, family or local organizations can help.

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).

For additional information, you can contact our team at info@howtouseabortionpill.org

You can do a test at least two weeks after unprotected sex or if your period is late.