A medication abortion involves taking two medications: mifepristone and misoprostol in order to end a pregnancy. These two medications work together to stop the growth of a pregnancy and allow the uterus to expel it.

Medication abortions are generally very safe, and, in fact, are much safer than carrying a pregnancy to term. It is normal to experience very strong cramping and a certain amount of bleeding during the abortion. Many people also experience flu-like symptoms such as fever, weakness, and body aches, as a side effect of the misoprostol. The possible complications include incomplete expulsion (not all the pregnancy tissue comes out) and excessive bleeding. Certain medications and medical conditions can increase the risk of someone have complications, which is why there are some questions on the intake form.

While these complications are fortunately very rare, it is important to know how to access the nearest emergency department, in the unlikely event of a complication. There, you should at all times be treated with the utmost care and respect, but if you are worried for any reason that this is not the case, then you do not have to state that you underwent a medication abortion, as a spontaneous miscarriage presents with the same symptoms as a medication abortion.

After you fill out your medical intake form (below), a doctor will reach out to you within 24 hours to go over your situation and make sure that the medication abortion is the safest and best option for you. This can also be a good time to talk about what birth control you would like to use moving forward, if that is something you are interested in. Once the consultation is done, the prescription is written and sent to a pharmacy that will ship you the medications within 72 hours in a discrete package.

As soon as you receive the medications in the mail, you can take them, but first, take a moment to prepare your environment. It’s good to have a safe, quiet space where you have private access to a toilet. You should have pain medicines such as ibuprofen (Advil) and acetaminophen (Tylenol) on hand, as well as large pads (no tampons), and a warm water bottle if you find that helpful.

First, you will take the mifepristone. Then, 12-24 hours later, you will take all four misoprostol. These can be placed under your tongue, in your vagina, or in your bottom. You should start bleeding within a few hours after taking the misoprostol.

Bleeding: If you soak through more than two large pads in one hour, you may be having too much bleeding. If the bleeding is not stopping, you should go to an emergency department. There they will probably do a pelvic exam to see if there is any leftover pregnancy tissue in your cervix that is making your uterus keep bleeding. If they are unable to see and remove the tissue with a speculum (the duck lips used during pap smears) and forceps (fancy tongs), they may need to use a small plastic tube to go inside your uterus to scrape out any extra tissue that is still bleeding. This is similar to how a surgical abortion is performed. They may also need to give you a blood transfusion if you are bleeding too much.

Infection: If you have a fever 48 hours after your medication abortion, or if you start to have very bad-smelling liquid coming from your vagina, there may be some leftover tissue in your uterus that is causing an infection. You should go to the emergency department, where they will likely insert a plastic tube through your vagina and cervix into your uterus to remove the infected tissue. This is similar to how a surgical abortion is performed. You will also probably need antibiotics, that will be given through your veins or by mouth.

Yes. A medication abortion does not affect your fertility in the short term or the long term, so you can become pregnant immediately after a medication abortion. If this is something you wish to avoid, it is important to use a good birth control method.