Medication Abortion Fact Sheet

How far along am I? Can I still get a medication abortion?

Medication abortions can happen if it has been less than 77 days since your last menstrual period(1). Pregnancy timing is measured by "gestational age," which starts on the first day of your last menstrual period (2), not when you get a positive pregnancy test. If you don't remember exactly when you started your last period, that's okay. Your medical provider can use an ultrasound to estimate your gestational age and let you know what your abortion options are (2). You can choose to have a procedural abortion instead, which takes 5 to 10 minutes in a clinic or doctor's office, where a provider will use suction to remove the pregnancy(3). Both options are safe and effective—the best option is whichever works best for you. You can see facts and compare your options with this comparison factsheet. Only go to verified providers for an ultrasound to confirm your gestational age. Many places that look like abortion clinics don't provide abortions and may lie to you about your healthcare options. These clinics are sometimes called limited service pregnancy centers, crisis pregnancy centers, or fake clinics, and often are not medically licensed. While they can give you an ultrasound, they may not be able to read it or may intentionally lie to you about your gestational age(4). Use a verified source to find a healthcare provider for your ultrasound, like ineedana.com, National Abortion Federation, or Planned Parenthood.

Where can I get a medication abortion?

Depending on where you live, medication abortion may be harder to get since some states might now restrict access(5). In New York State, abortions continue to be legal and available. Talk to an abortion provider in your area to learn what rules and restrictions are in place where you live. You can find a provider by searching ineedana.com, National Abortion Federation, or Planned Parenthood. If you're worried about someone else seeing your search history, you can use a privacy-focused browser like DuckDuckGo on your computer or Firefox Focus on your phone.

Is medication abortion safe?

Medication abortion is very safe and is a method used by millions of people each year. Severe complications occur in less than 1/3 of 1% of patients(6) and the risk of death for medication abortion is about 14 times less than your risk of giving birth(7). Having an abortion—either with medication or by a procedure in a doctor's office—does not impact your ability to get pregnant and have children later(8).

How does it work?

Medication abortion works through two medications—mifepristone and misoprostol—that you can get from a doctor's office or clinic or through the mail(5). Mifepristone is taken first to block the progesterone hormone which stops the pregnancy(9). One to two days later, four misoprostol pills are taken, which cause cramping and the emptying of the uterus. Instead of swallowing misoprostol like a typical pill, you either put misoprostol in the space between your teeth and your cheek and let it dissolve or put the pills in your vagina(6).

Is this the same as Plan B?

No. Mifepristone and Misoprostol medication abortion pills are used to end an existing pregnancy. The Plan B medication pills prevent pregnancy within 72 hours after sex. These medications can be referred to as "emergency contraception" but it is important to know the differences in what you need and practice safe sex(10). There are many contraceptive options available that you can learn more about on Planned Parenthood's website.

What should I expect during my abortion?

If you have a medication abortion, you won't need surgery or be put under anesthesia(11). You can take the first pill (mifepristone) in your medical provider's office, at home, or where you feel safe. You take the second round of pills (misoprostol) wherever you like. After you take the medication, you may feel nauseous, crampy, or tired and have diarrhea and/or a slight fever and chills(12). Most people start bleeding within an hour of taking misoprostol, but it could take longer. A medication abortion can feel like a heavy period or an early miscarriage with lots of cramping and clots(13). Some people describe a medication abortion as painful, and others describe it as uncomfortable—each person's experience is different and depends on their body(13).

How much does it cost?

The cost of your abortion depends on whether you have insurance (and what kind of insurance you have), where you live, and the gestational age of your pregnancy. The best way to find out how much your abortion will cost is to talk to your medical provider—they can help you figure out if insurance can cover some or all the cost of your abortion. If you need help paying for travel (including hotel, meals, or childcare during your abortion), The Brigid Alliance might be able to help. Abortion funds in every state may also be able to help you pay for care—you can look up your local abortion fund at this link.

What will I need to care for myself?

You are in charge of where you have your abortion and who is with you. Preparing for your medication abortion can help make the experience more comfortable. Wearing loose, comfortable clothing, having easy-to-reheat meals and snacks on hand, and a hot water bottle to help with cramps can help you feel more comfortable(14). You also want to have a supply of menstrual pads and some activities—movies, journals, coloring books, magazines, books to read, or friends to hang out with—to help you pass the time. Many people like to be close to a private bathroom after they take misoprostol since they will have heavy bleeding and might have diarrhea(13). If you experience pain or discomfort, you can take a hot shower or ibuprofen—do not take aspirin, which can worsen bleeding(12).

When should I consider going to the doctor?

Medication abortion is very safe, but it's important to know what warning signs to look out for that may require a visit to the doctor. Some bleeding is normal, but if you experience clots larger than a lemon or very heavy bleeding—bleeding through two or more pads in an hour for two hours in a row—along with severe stomach or back pain, foul-smelling discharge from your vagina, and/or a fever that lasts more than 1 day, you should call to see doctor(11).

What happens after my abortion?

It's normal to continue bleeding and spotting after your medication abortion. This might continue for a day or two or for several weeks until your next period(14). If you're worried about how much you are bleeding, you can use a pad to monitor how heavily you are bleeding and contact your provider. Medication abortion is very effective—for people who are 9 weeks pregnant or less, medication abortion works about 97% of the time(15) —but, in rare cases, people need follow-up care. To make sure the abortion worked, you will need a follow-up appointment with your medical provider about 1-2 weeks after you take the medication. They will confirm you're no longer pregnant using an ultrasound or blood test(12). You can take an at-home test instead (wait three weeks after taking your medication) and have a phone call or virtual visit with your medical provider(13). If you're still pregnant, you may need to take more medication or go to your doctor's office or clinic to have a procedural abortion(12). If you want to talk to someone about your experience, you have multiple options. You can text someone through the After-Abortion text line or talk to someone on the phone at All-Options, Connect and Breathe, or—to talk with open minded and non-judgmental clergy or religious counselors— Faith Aloud. You can also explore the resources on Abortions Welcome, which include suggestions for movement, medication, stories from other people who have had abortions, and other tools to prepare for your abortion or process it after the fact.

Sources

  1. Research, C. F. D. E. A. (2023). Information about Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. U.S. Food And Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/information-about-mifepristone-medicaltermination-pregnancy-through-ten-weeks-gestation
  2. Pregnancy Week By Week | First Month Symptoms and Signs. (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/pregnancy/pregnancy-month-by-month
  3. Vacuum Aspiration | Kaiser Permanente (n.d.). Kaiser Permanente. https://healthy.kaiserpermanente.org/health-wellness/healthencyclopedia/he.vacuum-aspiration.tw1078
  4. Montoya, M., Judge-Golden, C., & Swartz, J. (2022, June 8). The Problems with Crisis Pregnancy Centers: Reviewing the Literature and Identifying New Directions for Future Research. International Journal of Women's Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9189146/pdf/ijwh-14-757.pdf
  5. Medication abortion. (2023, July 28). Guttmacher Institute. https://www.guttmacher.org/state-policy/explore/medication-abortion
  6. Redford, G. (2022, September 20). What is medication abortion? Your questions answered. AAMC. https://www.aamc.org/news/what-medication-abortion-your-questions-answered
  7. Raymond EG, Grimes DA. The comparative safety of legal induced abortion and childbirth in the United States. Obstet Gynecol. 2012 Feb;119(2 Pt 1): 215-9. doi: 10.1097/AOG.0b013e31823fe923. PMID: 22270271. https://pubmed.ncbi.nlm.nih.gov/22270271/
  8. Is the Abortion Pill Safe? | Read About Abortion Pill Safety. (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/abortion/the-abortion-pill/how-safe-is-the-abortion-pill
  9. Wallis, C. (2022). Abortion pills are very safe and effective, yet government rules still hinder access. Scientific American. https://doi.org/10.1038/scientificamerican0322-26
  10. Hoperising, Hoperising, & Hoperising. (2023). Is there a difference between Plan B pill and abortion pill? Hope Rising -. https://hoperising.org/is-there-a-difference-between-plan-b-pill-and-abortion-pill/
  11. Medical abortion - Mayo Clinic. (n.d.). https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac20394687#:~:text=Signs%20and%20symptoms%20that%20may,lasting%20more%20than%2024%20hours
  12. How does the abortion pill work? | Abortion pill function. (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/abortion/the-abortion-pill/how-does-the-abortion-pill-work
  13. Carafem. (2023). Thinking about the abortion pill? Here's what you can expect. Carafem. https://carafem.org/abortion-pill-effects/
  14. Carafem. (2023a). After Abortion Care: symptoms to watch for & recovery tips. Carafem. https://carafem.org/abortion-recovery/
  15. The safety and quality of abortion care in the United States. (2018). In National Academies Press eBooks. https://doi.org/10.17226/24950