Read and follow the instructions on your prescriptions exactly.
Step 1: Take the first medication (mifepristone).
- You'll take it at a clinic or at home, depending on local regulations.
Step 2: Take the second medication (misoprostol) 24 to 48 hours after the first.
- Before you take it, take the pain and/or nausea medication you were prescribed.
- Misoprostol typically starts working within a few hours and will cause bleeding and cramping.
Optional Step 3: If you're more than 9 weeks pregnant, take a second round of misoprostol 4 hours after the first.
For more detailed instructions, watch this video from Planned Parenthood or see this diagram.
Watch this video from Planned Parenthood on what to expect.
During the first 24 hours, you may experience:
- Mild to intense cramps similar to or stronger than period cramps. They usually start 1 to 4 hours after taking the second medication (misoprostol) and may last a few hours.
- Heavy bleeding after taking the second medication (misoprostol). The heaviest bleeding usually happens within the first 4 to 6 hours but can continue for a few days. You may also pass large clots as the pregnancy is expelled.
- Nausea, vomiting, diarrhea, dizziness, chills, or a mild fever. These side effects usually go away within a day of taking the misoprostol.
After the first 24 hours:
- You may have heavy bleeding for a few days. After that, most women experience moderate to light bleeding for a few more days to weeks.
- Your other side effects (stomach upset, chills, mild fever, dizziness, etc.) should be gone.
Heavy bleeding is normal, but contact a health care provider if:
- You're soaking through more than 2 pads or tampons an hour for 2 hours in a row at any time
- Bleeding gets heavier after the first 24 hours of bleeding
Reach out if you have any of the following:
- A high fever (100.4° F or 38° C) for more than a few hours
- Bleeding that becomes heavier after the first 24 hours of bleeding
- No bleeding within 24 hours of taking the second medication
- Severe pain that doesn't get better with pain medication
- Foul-smelling vaginal discharge
Go to the emergency room right away if:
- You're soaking through more than 2 pads or tampons an hour for 2 hours in a row
- You feel like you're going to pass out
Pain relief:
- Try over-the-counter painkillers like ibuprofen to ease cramping.
- Avoid aspirin — it can increase bleeding.
- Take any other pain medications prescribed by your medical provider.
- Try a heating pad, hot shower, or bath.
Comfort and rest:
- Plan to rest at home, especially the day you take misoprostol.
- Set up a comfortable space.
- Have heat packs, blankets, and pads on hand.
- Having a support person nearby can also help.
Hydration and nutrition:
- Drink plenty of fluids.
- Try to eat small, light meals to keep your energy up, especially if you're feeling nauseous or weak.
Emotional care:
- You may have many different emotions. They're all normal. Some people feel relief; others find it very upsetting or intense.
- Take time for yourself and seek support from trusted friends, family, or a counselor if needed.
You'll have a follow-up appointment 1 week later.
- This may be virtual or in person.
- The goal is to make sure the abortion is progressing as expected.
Follow-up testing:
- You'll take either a blood pregnancy test 1 week later or a urine pregnancy test 4 to 6 weeks later. It can take some time to test fully negative, so don't worry too much if the first one is still positive.
- You may get an ultrasound if the exam is in person.
Medication abortions are highly effective. But if the pregnancy continues, a surgical procedure may be needed to complete the process.
For emotional support, try contacting one of these resources:
Additional options:
- Miscarriage & Abortion Hotline for clinical support
- Repro Legal Helpline for legal questions
- Trans Lifeline for trans-specific support
Learn how the medications work, the symptoms you might experience, and how to take care of yourself through the process.
