How to Use the Abortion Pill

Medication abortion now accounts for more than half of the abortions in the United States. But many are unaware of how it works.

Also known as the abortion pill, medication abortion is safe and effective for up to at least 10 to 12 weeks into a pregnancy. According to a 2022 poll, only 13% of respondents said they had heard, read, or seen “a lot” about the abortion pill, while 24% of respondents had never heard of the abortion pill.

The abortion pill consists of two medicines—mifepristone and misoprostol—made up by five pills. We'll walk you through how these pills work and what you can expect after taking them.

Step 1: Take a Mifepristone Pill

Mifepristone is the first pill. You take it by mouth to terminate an early pregnancy. This is a single tablet with 200 mg of mifepristone, which blocks a hormone called progesterone and stops the pregnancy.

You may experience cramping or nausea after taking mifepristone, but according to Planned Parenthood, this is more common after the second medicine, misoprostol.

In anticipation of cramping that may occur after the second medication, Planned Parenthood recommends taking ibuprofen about 30 minutes before the second treatment.

Step 2: Take 4 Misoprostol Pills

Between 24 to 48 hours after mifepristone, you will take the second medicine called misoprostol. It works by emptying the uterus and it may cause cramping and bleeding—similar to a miscarriage.

Misoprostol comes in four 200 µg tablets. They are typically in a hexagon shape. You can take the pills in one of the following ways.

How to Take Misoprostol Buccally

If you choose to take misoprostol buccally, you will:

• Put four misoprostol tablets between your cheek and your gum, two on each side of your mouth.
• Hold the pills there for 30 minutes as they dissolve.
• Swallow what's left of the pills with water.

How to Take Misoprostol Vaginally

If you choose to take misoprostol vaginally, you can insert the pills 0 to 48 hours after taking mifepristone. You will:

• Empty your bladder and wash your hands.
• While lying down, use your index finger to insert the four pills inside your vagina as far up as they can go. This is to get the pills toward the cervix and to reduce the risk of the pills falling out.
• Wait for 30 minutes before moving around. Some clinics recommend that people lie down for at least an hour after inserting the pills. You won't have to insert the pills again if they come out.

After taking misoprostol, you may experience period-like cramping within one to four hours. You will likely experience bleeding four to six hours after insertion, but the process can be longer for some people.

If you feel pain during the process, you could take painkillers or use a hot water bottle. If you have irregular, smelly discharge or excessive bleeding, you should contact your healthcare provider.

When the pregnancy is passed, you may notice blood clots or fleshy pieces in your discharge. You may also experience period-like bleeding for about 10 days after the abortion.

Step 3: Care for Yourself After an Abortion

After a medication abortion, take extra care of yourself. You might experience physical discomfort from the cramps and bleeding, or emotional distress due to hormonal changes. You might also feel stressed or scared depending on the amount of social support you have and the state you live in.

Based on recommendations from Planned Parenthood, you can prepare the following ahead of time to make the abortion process as comfortable as possible:

• Stock up on maxi pads
• Get a heating pad or hot water bottle for cramps
• Have books, movies, or TV shows ready to help pass time
• Stock up on your favorite comfort food
• Have a friend or partner rub your back or fetch you supplies

If you need counseling or support, you can also call the All-Options hotline at 1-888-493-0092 to talk about your feelings and experience at any point in your pregnancy or abortion process.

Correction - March 16, 2023: A previous version of this article incorrectly stated that mifepristone alone can terminate a first-trimester pregnancy safely. It has been corrected to misoprostol.