“Abortion with pills,” also called a medication abortion, is a modern option for ending an early pregnancy (before 10 weeks) safely and effectively through a combination of medications: mifepristone and misoprostol (or miso only, if mifepristone is not available). Mifepristone blocks the hormone progesterone which stops the growth of the pregnancy; misoprostol causes the uterus to cramp and expel what’s within, effectively inducing miscarriage.

There are two types of abortion with pills:

1) Mifepristone plus misoprostol: You take the mifepristone pill first, followed 24 to 48 hours later with misoprostol pills. This is the most effective method of abortion with pills (95-98% of the abortions are successful). It has the fewest side effects and is approved by the U.S. Food and Drug Administration (FDA). This is the type of abortion with pills provided by Planned Parenthood and recommended by the American College of Obstetricians and Gynecologists.

2) Misoprostol only: Abortion with pills can also be done using only misoprostol pills. This is less effective than when mifepristone and misoprostol are both taken (about 85% of the abortions are successful). The World Health Organization endorses the use of misoprostol alone for early abortion when mifepristone is not available.

Both methods are effective and very safe. Both methods are also widely used by women around the world.

Watch a video from the International Planned Parenthood Federation about how abortion pills work.

Using abortion pills is very safe. Abortion pills are safest for pregnancies of less than 10 weeks (less than 70 days, counting from the first day of the last regular period). The rate of major complications during an early abortion is very low, and the earlier in pregnancy you get an abortion, the lower the chances are of complications.

It is better to use mifepristone plus misoprostol because it is more effective. But sometimes mifepristone pills are hard to find in the United States. The World Health Organization says it is safe to use misoprostol alone when mifepristone is not available.

One risk is that abortion pills may not work (they may not end the pregnancy). The pills are less effective when only misoprostol is used or when the pills are taken later in pregnancy. Most providers recommend doing a pregnancy test 3-4 weeks after taking the pills to make sure they worked. If the test is positive, it is important to get follow-up care. (Note: a pregnancy test done earlier than 3-4 weeks after an abortion may show a false positive because it takes time for the pregnancy hormones to leave the body.)

Another risk is if the pregnancy is outside the womb. This is called an ectopic or tubal pregnancy. This is very rare (only about 2 of every 100 pregnancies). In these cases, the abortion pills will not work and the person will need immediate medical attention, which can be obtained at any medical facility. Because of this small risk, it is important to always do a pregnancy test 3-4 weeks after taking the pills and to seek immediate care if the test is positive. It is also important to seek care if there are any continued signs or symptoms of pregnancy after the abortion (such as severe and increasing abdominal pain, particularly if it is one sided). Ectopic pregnancy is rare but can lead to serious health consequences.

Abortion pills are FDA approved up to the first 10 weeks of pregnancy. This calculator can help you know how many weeks pregnant you are (based on the first day of your last normal period). People who don’t know the first day of their last period or who have periods that don’t come regularly may need to have an ultrasound or pelvic exam to find out how many weeks pregnant they are.

Abortion pills cause bleeding and cramping. This is a natural part of the abortion process and shows that the pills are working. Many people do not have any symptoms after taking the first pill (mifepristone). The bleeding and cramping usually start soon after taking the second set of pills (misoprostol).

The bleeding may be heavier than a normal period and the cramping can be mild to severe. This can vary for each person and by how far along the pregnancy is.

Other common side effects include feeling sick to your stomach, throwing up, diarrhea, headache, dizziness, and fevers.

Please seek immediate help from a medical professional if you have any of these severe symptoms:

• bleeding that soaks through more than 2 maxi sanitary pads per hour for more than 2 hours in a row, OR
• fever of more than 100.4 degrees Fahrenheit for more than 24 hours, OR
• fever of more than 102.2 degrees Fahrenheit for any length of time

How to prepare:
To prepare for taking the second medication at home, abortionfinder.org recommends gathering the following supplies in advance:

• A heating pad
• Comfortable clothes, including comfy underwear
• Super absorbent maxi pads
• A blanket in case you have chills
• Ice chips and/or popsicles to suck on in case you have nausea or vomiting
• Easily digestible food like plain crackers, white rice, bananas, broth, and plain white bread
• Something to distract you, like movies, tv, magazines, coloring books, or video games
• A friend or other support person to keep you company and help you with anything you need help with.