What to Expect with the Abortion Pill (Medication Abortion)
At your visit, a medical assistant will perform an ultrasound. You will discuss your decision and options and talk more about the medications, side effects, and risks outlined in the Medication Guide.
Your vital signs (blood pressure, heart rate, and temperature) will be taken, then you will meet with the physician. The physician will ask you about your decision and answer any questions you may have. The physician will then give you one mifepristone tablet to take orally immediately and a packet containing misoprostol to take home. If your blood type is Rh negative, a nurse will administer an injection of Rhogam in the recovery room.
The misoprostol should be taken 24-48 hours after swallowing the mifepristone tablet at AWC. We recommend taking 800 mg of ibuprofen (Advil, Motrin, Nuprin, etc.) 30 minutes before you plan to take the misoprostol tablets. All 4 misoprostol pills should be left in the mouth to dissolve for approximately 30 minutes. Anything left in the mouth after 30 minutes should be swallowed. Contractions and bleeding should begin between 20 minutes and 4 hours after taking misoprostol. This may take up to 24 hours.
Most people can expect very heavy bleeding for several hours with this method, and it is normal to pass some large clots. Cramping is normal with this type of abortion and may be much worse than a period. Bleeding may continue on and off for several days or weeks and may range from a light flow or spotting to heavier, period-like bleeding. However, if you do not begin bleeding within 24 hours or you are soaking through 2 or more pads per hour for 2 hours in a row, please call AWC immediately.
Sometimes nausea, vomiting, diarrhea, weakness, or a fever can be side effects of the mifepristone and misoprostol tablets. These are considered normal in the first 24 hours after taking the misoprostol.
If more than 24 hours have passed, and you experience any of these symptoms, call our office immediately.
A temperature of 101°F or higher can be normal after taking Misoprostol. Your temperature should return to normal about one hour after the bleeding starts. Drink lots of fluids. If your fever does not return to normal in three hours call the clinic. If you get a fever above 100.4°F after day 4, please call our office immediately.
Approximately 7-10 days after your initial visit, we encourage you to have a follow-up. You have the choice of returning to AWC for a repeat ultrasound, speaking to our nurse over the phone, or seeing your own doctor.
In approximately 1% of cases using the abortion pill method, the pregnancy is not ended; 2-3% will have remaining pregnancy tissue in the uterus at the time of the follow-up appointment. If you are still pregnant, you will most likely need a procedure to complete the abortion.
If the abortion is complete, you may discuss birth control options and future care.
Post-abortion bleeding and cramping varies from person to person. You may bleed for 2 days to 4 weeks or have no bleeding at all. For many people, the bleeding stops and starts sporadically. There may be spotting until your next period. You may also find that you are passing large blood clots and have mild to moderate or even heavy cramping. All of this can be normal.
See our Abortion After-Care Instructions [PDF] for more details.