How to Take Abortion Pills: Step by Step Instructions

Source: Reproductive Health Access Project & M+A Hotline

There are two methods for using abortion pills to help stop a pregnancy. Both methods work well, are very safe, and are used by many people all around the world.

Method 1:
Mifepristone + Misoprostol

This method is 95% - 98% effective and is very safe. The Food and Drug Administration (FDA), which makes sure medicines are safe, has approved this method.

Method 2:
Misoprostol only

This method is also very safe and effective. The World Health Organization supports this method, which is used by many people around the world where mifepristone is not available.

Method 1

Mifepristone + Misoprostol

This method is 95% - 98% effective and is very safe. The Food and Drug Administration (FDA), which makes sure medicines are safe, has approved this method.

1

Check your dates

Calendar

Use a calendar or a gestational age calculator. Measure from the first day of your last period to today.

2

(Optional) Take a pregnancy test

Urine pregnancy test

You may already know you are pregnant from your symptoms.

  • You can take a pregnancy test.
  • You can choose not to confirm a pregnancy and still take pills.
3

Be sure that you do not have:

  • Long term treatment with steroids (nasal, inhaled, or topical steroids are ok)
  • Symptoms of ectopic pregnancy (severe tummy pain on 1 severe and vaginal bleeding)
  • Bleeding problem or treatment with a blood thinner (aspirin is ok)
4

The pills

Mifepristone and Misoprostol

You will use two types of pills:

  • The first is mifepristone.
  • The second is misoprostol.

If you need to get pills, you can search for an abortion pill provider using the Plan C Guide.

5

How to take the pills

How many weeks has it been since your last period? (select one)

How to take pills if you are less than 9 weeks pregnant:

  1. Take mifepristone

Wait 24-48 hours

  1. Take pain medication
  2. Use 4 misoprostol pills (see instructions below)

How to take pills if you are 9-12 weeks pregnant:

  1. Take mifepristone

Wait 24-48 hours

  1. Take pain medication
  2. Use 4 misoprostol pills (see instructions below)
  3. Wait 4 hours
  4. Use 4 more misoprostol pills

How to take pills if you are more than 12 weeks pregnant:

  1. Take mifepristone

Wait 24-48 hours

  1. Take pain medication
  2. Use 2 misoprostol pills (see instructions below)
  3. Wait 3 hours
  4. Use 2 misoprostol pills
  5. Repeat 2 misoprostol pills every 3 hours until pregnancy passes.
6

First day: Take mifepristone

Person taking abortion pills

Swallow one 200-mg pill. Most people don't feel anything after taking mifepristone, but some people do have some bleeding, nausea or cramping.

If you have cramps you can use pain medication. If you have nausea you can use anti-nausea medication (dramamine, benadryl or zofran are examples).

7

Second day: Take pain medication

Bottles of pain medication

You can take up to four 200-mg ibuprofen pills or up to two 500-mg acetaminophen pills every 6 hours as needed. Or you can take up to two 220-mg naproxen pills every 12 hours.

You can take any of these pain pills before or after misoprostol. You can take more if needed - follow the directions on the package.

8

Use misoprostol

Three ways to take misoprostol pills: inside cheek, under tongue, in vagina

Use the table in Step 5 to find how many misoprostol pills to take and when to take them.

You can put pills inside your cheeks, under your tongue, or in your vagina. Choose the method that feels best to you. Do this about 24 hours after swallowing the mifepristone.

  • For Mouth: Put pills inside each cheek or under your tongue. Hold them there for 30 minutes while your body absorbs the medicine. It's ok to swallow your saliva. Then swallow the pills with a drink.
  • For Vagina: Put pills in your vagina. Lie down for 30 minutes as your body absorbs the medicine. If the pills fall out after 30 minutes, throw them away or flush them.

If abortion care is banned in your state, it is safest to put the pills inside your cheeks or under your tongue. This way, there will be no pill pieces left behind in the event that you need a medical exam.

9

Side effects

Person experiencing menstrual cramps

Cramps and heavy bleeding should start within 24 hours after misoprostol.

  • If you have no cramps and bleeding after 4-6 hours, you can use 2 more misoprostol pills.
  • You may see blood clots.
  • You may have diarrhea, fever, or chills.
  • If you use misoprostol in the mouth, it can make your tongue sore. Misoprostol can also cause nausea, vomiting, diarrhea, fever, chills, shaking - that is normal and should get better within 24 hours.
  • If you have nausea you can use anti-nausea medication (benadryl, dramamine or zofran are examples).

If you're more than 8-9 weeks, you may see fetal remains and wonder what to do with them. You can contact ReproLegal Helpline for peer support or the M&A Hotline for clinician support. The ReproLegal Helpline can help you understand your legal risks. This is important because some people have gotten in trouble for what they did with fetal remains.

10

How much bleeding is too much?

4 soaked sanitary pads

If you soak through 2 large overnight pads per hour, for 2 hours in a row, you should contact a clinician.

You can always call or text the M+A Hotline for free, confidential medical support.

M+A Hotline
(833) 246-2632

Visit Website

11

After the abortion

Birth control pack and a syringe

The heavy bleeding should slow down within 24 hours. You might bleed on-and-off for a few weeks after the abortion.

Contact your provider if:

  • you don't bleed after using misoprostol
  • you still have heavy bleeding a few days after the abortion
  • you still feel pregnant

Your pregnancy symptoms should go away after you use the pills. Pregnancy tests can stay positive 5 weeks after the abortion. If you're not sure if the abortion worked, you can get an ultrasound. You can have sex again when you feel ready.

You can get pregnant again as soon as 8 days after an abortion. Most birth control methods can be started right after an abortion.

Important: If you had an abortion after 12 weeks and your blood type is rH negative (A-, B-, O-, AB-), you should get a shot called Rhogam. This prevents problems in future pregnancies. You should get the shot within 2 days of the abortion.

Where to Get Rhogam
How to Find Your Blood Type

Video

How to Use Abortion Pills

Method 2

Misoprostol Only

This method is also very safe and effective. The World Health Organization supports this method, which is used by many people around the world where mifepristone is not available.

1

Check your dates

Calendar

Use a calendar or a gestational age calculator. Measure from the first day of your last period to today.

2

(Optional) Take a pregnancy test

Urine pregnancy test

You may already know you are pregnant from your symptoms.

  • You can take a pregnancy test.
  • You can choose not to confirm a pregnancy and still take pills.
3

Be sure that you do not have:

  • Long term treatment with steroids (nasal, inhaled, or topical steroids are ok)
  • Symptoms of ectopic pregnancy (severe tummy pain on 1 severe and vaginal bleeding)
  • Bleeding problem or treatment with a blood thinner (aspirin is ok)
4

The pills

4 packs of misoprostol pills

You need 12-16 misoprostol pills. Each one is 200mcg.

If you need to get pills, you can search for an abortion pill provider using the Plan C Guide.

5

How to take misoprostol

How many weeks has it been since your last period?

  1. Use 4 misoprostol pills every 3 hours (12 pills total, see instructions below).
  2. If no bleeding occurs after the 3rd time, you can use 4 more misoprostol pills 3 hours later

Use 2 misoprostol pills every 3 hours until the pregnancy passes (see instructions below).

6

Take pain medication

Bottles of pain medication

You can take up to four 200-mg ibuprofen pills or up to two 500-mg acetaminophen pills every 6 hours as needed. Or you can take up to two 220-mg naproxen pills every 12 hours.

You can take any of these pain pills before or after misoprostol. You can take more if needed - follow the directions on the package.

7

Use misoprostol

Three ways to take misoprostol pills: inside cheek, under tongue, in vagina

Use the table in step 6 to find how many misoprostol pills to take and when to take them.

You can put pills inside your cheeks, under your tongue, or in your vagina. Choose the method that feels best to you.

  • For Mouth: Put pills inside each cheek or under your tongue. Hold them there for 30 minutes while your body absorbs the medicine. It's ok to swallow your saliva. Then swallow the pills with a drink.
  • For Vagina: Put pills in your vagina. Lie down for 30 minutes as your body absorbs the medicine. If the pills fall out after 30 minutes, throw them away or flush them.

If abortion care is banned in your state, it is safest to put the pills inside your cheeks or under your tongue. This way, there will be no pill pieces left behind in the event that you need a medical exam.

8

Side effects

Person experiencing menstrual cramps

Cramps and heavy bleeding should start within 24 hours after misoprostol.

  • If you have no cramps and bleeding after 4-6 hours, you can use 2 more misoprostol pills.
  • You may see blood clots.
  • You may have diarrhea, fever, or chills.
  • If you use misoprostol in the mouth, it can make your tongue sore. Misoprostol can also cause nausea, vomiting, diarrhea, fever, chills, shaking - that is normal and should get better within 24 hours.
  • If you have nausea you can use anti-nausea medication (benadryl, dramamine or zofran are examples).

If you're more than 8-9 weeks, you may see fetal remains and wonder what to do with them. You can contact ReproLegal Helpline for peer support or the M&A Hotline for clinician support. The ReproLegal Helpline can help you understand your legal risks. This is important because some people have gotten in trouble for what they did with fetal remains.

9

How much bleeding is too much?

4 soaked sanitary pads

If you soak through 2 large overnight pads per hour, for 2 hours in a row, you should contact a clinician.

You can always call or text the M+A Hotline for free, confidential medical support.

M+A Hotline
(833) 246-2632

Visit Website

10

After the abortion

Birth control pack and a syringe

The heavy bleeding should slow down within 24 hours. You might bleed on-and-off for a few weeks after the abortion.

Contact your provider if:

  • you don't bleed after using misoprostol
  • you still have heavy bleeding a few days after the abortion
  • you still feel pregnant

Your pregnancy symptoms should go away after you use the pills. Pregnancy tests can stay positive 5 weeks after the abortion. If you're not sure if the abortion worked, you can get an ultrasound. You can have sex again when you feel ready.

You can get pregnant again as soon as 8 days after an abortion. Most birth control methods can be started right after an abortion.

Important: If you had an abortion after 12 weeks and your blood type is rH negative (A-, B-, O-, AB-), you should get a shot called Rhogam. This prevents problems in future pregnancies. You should get the shot within 2 days of the abortion.

Where to Get Rhogam
How to Find Your Blood Type