If you’re considering the abortion pill and want to understand more about what it involves, you’re not alone — many women have questions when facing this decision.
It’s completely normal to feel a mix of emotions and want clear, unbiased information before moving forward.
Knowing how the abortion pill works, what to expect physically and emotionally, and what resources are available to you can help you make a fully informed choice that is right for you. You deserve to have your questions answered with compassion and without pressure.
What is the abortion pill?
The abortion “pill” is more than just a pill. It is a two-step regimen intended to end an early pregnancy (10 weeks or less).
Sometimes referred to as a chemical or medication abortion, the abortion pill is a combination of two drugs: mifepristone and misoprostol. According to the drug label, this process is most effective (96%) if completed before eight weeks gestation. If the abortion pill is accidentally taken in the second trimester, 39% of women will need surgery to complete the abortion. That’s why it’s important to confirm gestational age with an ultrasound.
How does the abortion pill work?
According to the FDA step one of the regimen is to take 200 mg of the drug mifepristone, commonly referred to as RU486, or by its brand name, Mifeprex. Mifepristone blocks the body’s natural production of progesterone which is needed to sustain a pregnancy.
Step two utilizes the drug misoprostol, also knowns as Cytotec. 24-48 hours after taking Mifeprex, 800 mcg of misoprostol should be taken buccally (in the cheek pouch) or vaginally at a location where the patient feels most comfortable. Misoprostol softens the cervix and causes uterine contractions (cramping), which will expel the pregnancy from the body.
Your provider should ensure you have a scheduled follow-up appointment seven to 14 days after completing the abortion pill regimen to ensure the abortion was completed successfully and no infection exists.
Do I need to have an ultrasound before taking the abortion pill?
Ultrasounds are the most reliable way to determine how far along you are in your pregnancy. Additionally, ultrasounds are the only way to confirm you do not have an ectopic pregnancy. An ectopic pregnancy is a pregnancy that occurs outside of the uterus. The abortion pill is not a reliable way to end an ectopic pregnancy. While it may successfully terminate the pregnancy, it cannot remove the embryo from your body, therefore increasing your risk of serious complications, such as internal bleeding or infection.
Parkville Women’s Clinic offers a variety of services, including a limited OB ultrasound to confirm an intrauterine pregnancy, detect fetal cardiac activity, and estimate gestational age. This information will help you decide if the abortion pill is right for you.
What can I expect after taking the abortion pill?
During the abortion pill process, particularly after taking misoprostol, you will likely bleed more than a period. You will pass large blood clots – up to the size of a lemon – as well as the fetus or embryo. It is important to prepare yourself mentally and emotionally for this process, particularly if your pregnancy is eight weeks along or later.
There is no right or wrong way to feel so it is important to have your trusted support system in place to help you process your emotions and monitor physical side effects.
What are the possible side effects and risks of the abortion pill?
While the drug label reports serious adverse side effects as less than 0.5%, the latest study analyzing insurance claims from mifepristone abortions concluded that out of 865,727 women who were prescribed mifepristone abortions from 2017-2023, 10.9% reported adverse side effects. These women experienced sepsis, infection, hemorrhaging, or another serious adverse event within 45 days of taking mifepristone.
Common side effects include:
- Cramping and vaginal bleeding
- Nausea
- Weakness
- Fever/chills
- Vomiting
- Headache
- Diarrhea
- Dizziness
More serious side effects include:
- Incomplete abortion
- Heavy bleeding that requires surgery
- Blood clots in uterus
- Serious infection
- Severe or persistent abdominal pain
What should I do if my side effects persist?
Go to the nearest emergency room if:
- You are bleeding through two regular-sized sanitary pads per hour for more than two hours
- You are passing blood clots larger than a lemon
- You have a fever of 100.4˚ F or higher for longer than four hours
- You have persistent nausea, stomach pain, or weakness
- You are feeling depressed and are having thoughts of hurting yourself
In order for emergency room personnel to properly diagnose and treat you, it is important that you be upfront and honest about taking the abortion pill.
According to an article published by the Charlotte Lozier Institute and backed by the research of Health Services Research and Managerial Epidemiology, abortions miscoded as miscarriages in the ER were more likely (by as much as 78%) to result in hospitalization. Furthermore, they were twice as likely to be admitted for surgery for retained products of conception (RPOC).
Where can I get more information?
At Parkville Women’s Clinic we are here to provide you with real support and real answers so you can be fully informed and empowered within your unique situation.
Our services range from pregnancy testing and support to STI testing and treatment to ensure your sexual health is put first. We have nursing staff on site to confirm a pregnancy and provide you with the support you need going forward. All at no charge.