How to use abortion pills

How to take the pills

NOTE: If you are very nauseous or vomiting a lot, see info below for suggestions to help with that before you take the pills.

Day 1: Swallow the 1 mifepristone pill with water.

Day 2 (24 hours later): Take ibuprofen (Advil or Motrin) 800mg (4 over-the-counter pills) or naproxen (Aleve) 440 mg (2 over-the-counter pills) by mouth. If you are allergic to ibuprofen, you can take acetaminophen (Tylenol) 1000 mg by mouth instead.

Then take 4 misoprostol pills.  Put 4 pills under your tongue. Hold them there for 30 minutes or until they dissolve. After 30 minutes, swallow whatever remains of the pills.

3 hours later, take another 2 misoprostol pills.

3 hours later, take another 2 misoprostol pills.

You will have some misoprostol pills left over afterwards. Do NOT throw them away. Keep them in case you have a problem later and we tell you to take them. 

NOTE: Sometimes bleeding happens after taking mifepristone. You still need to take the misoprostol. Follow all the steps to make sure the process works.

What to expect

Bleeding and cramping:

• Cramping and bleeding should start after taking the second med, misoprostol.  Follow all the steps even if you already started bleeding.
• Sometimes it can take 24 hours after the last step for the bleeding to start.
• Bleeding can be heavier than a normal menstrual period and may include clots.  When you are less than 6 weeks pregnant you may have less bleeding than a period.
• The pain can be very strong for some people. Please see pain meds info below.
• Bleeding will start to slow down after the pregnancy is out.
• Bleeding continues off and on until your next normal period, which comes in 4-8 weeks.

Pain management:

• Keep taking ibuprofen every 8 hours or naproxen every 12 hours and/or Tylenol every 6 hours as needed for pain. Intense cramps means it is working.
• You can also use a heating pad or hot water bottle.
• Being in a comfortable environment, listening to music, and having someone to support you can also help.

Side effects:

• Nausea, vomiting, diarrhea, fever, and chills are all normal side effects of misoprostol.
• Side effects normally go away on their own after a few hours.

Managing nausea:

• Eat small amounts of food regularly and sip on fluids.
• Try an over-the-counter med for nausea:

1. Doxylamine succinate (Unisom)
2. Dimenhydrinate (Dramamine)
3. Emetrol
4. Bismuth subsalicylate (Pepto-Bismol)
5. Ginger tea, ginger ale, or ginger candies
6. Vitamin B6
7. You can also ask your medical provider for a prescription. Some common meds prescribed for nausea are:
1. Ondansetron (Zofran)
2. Promethazine (Phenergan)

• When you might need more medication:

• Mifepristone: Vomiting  more than 30 minutes after swallowing the Mifepristone will not affect the abortion.  If you vomit less than 30 minutes after swallowing the mifepristone, let us know and we will guide you.
• Misoprostol: If you vomit less than 15 minutes after putting the misoprostol under your tongue, take the same dose again right away. 

What you might see:

• Under 9 weeks, you won’t see much more than blood and clots. You could see a small amount of white pregnancy tissue like a piece of sponge.
• After 9 weeks, you might see an embryo about the size of a coffee bean after 9 weeks.
• At 12 weeks, you might see a fetus about the size of a plum. 
•  At 14 weeks, you might see a fetus about the size of a lemon.
• Seeing a fetus after 14 weeks can be upsetting for some people. It is good to be prepared and have a plan for how to dispose of the fetal  tissue. See the bottom of this email for more resources to support you with this.

After the abortion

You do not need a follow-up appointment with a doctor if you had bleeding and cramping and you no longer feel pregnant after a couple of weeks.

If you don’t bleed after the pills or still have pregnancy symptoms after 2 weeks, please email us.

You can take a pregnancy test 5 weeks after the abortion.A pregnancy test before 5 weeks may still be positive.  If your test is positive, take a picture of it when you read it. Then repeat the test in 3-4 days to see if the line is getting fainter. Make sure to use a test with lines. Do not use Clear Blue brand tests because they can give false positive results.

You can go back to your normal activities, including having sex, when you feel ready.

You can get pregnant as soon as 8 days after an abortion. For information on birth control you can go to Bedsider.

When to seek help

An abortion with pills is very safe and very effective.

If you have any concerns during the process, you can call or text the Medical Line for Aid Access at 1-888-963-1144. Our medical providers are available from 12pm-9pm EST (9am-6pm PST).

 Call us right away if you have of the following: 

1. Heavy bleeding that fills a large pad for two hours in row.
2. Fever over 100.4 F.
3. Pain that is not going away with ibuprofen.

If you have the following symptoms, please go to the hospital right away:

1. Heavy bleeding that fills 2 pads per hour for more than 2 hours in a row and that is so heavy you feel dizzy or light-headed. Before leaving for the hospital, take 2 misoprostol pills under your tongue to help stop the bleeding.
2. Fever more than 101.4° F for more than 24 hours or fever more than 102° F at any time in case you have an infection that needs treatment with antibiotics.
3. Severe pain that does not go away with pain medication. 

What to say at the hospital: You do NOT have to say that you took abortion pills. They cannot be detected. You can just say you are pregnant and bleeding.

Additional info

• For more information about abortion with pills, visit the Aid Access FAQ page.
• For legal information about doing an abortion yourself at home, call the Repro Legal Helpline (844-868-2812).
• For emotional support, call/text Reprocare (833-226-7821) or Exhale (617-749-2948)
• You can read more about how to prepare yourself here. 
• Email our help desk at info@aidaccess.org

Click here to download very easy to understand instructions