How Does the Abortion Pill Work for a Medication Abortion?

Medically Reviewed By Alexandra Perez, PharmD, MBA, BCGP

The abortion pill is a medication that ends a pregnancy. A doctor must prescribe the abortion pill, and they may carry out additional steps, such as blood work or an ultrasound, before prescribing it. The abortion pill is not available over the counter. A medical abortion requires the pregnant person to take two different medications, so the “abortion pill” is actually two pills.

More than half of abortions performed at week 8 or earlier in the United States are medication abortions.

This article will explain more about the abortion pill, including who is eligible to take it, how effective it is, how it works, what risks and side effects there may be, and what to expect afterward. 

What is the abortion pill? 

Woman on beach taking photos with retro film camera
Julia Gunther/Getty Images

The abortion pill is a medication used to end a pregnancy. This process is called a medication abortion or a medical abortion.

There are two ways that a pregnancy can be ended. These are:

  • a medication abortion, in which a medication will terminate the pregnancy and induce the body to expel the pregnancy contents
  • a procedural abortion, in which a doctor surgically removes the pregnancy contents

The Food and Drug Administration (FDA) has approved the use of medication abortion in pregnancies up to 10 weeks. However, some doctors do prescribe medication abortion up to 11 weeks of pregnancy. 

How does the abortion pill work?

The abortion pill requires a pregnant person to take two different medications in the following order: 

  1. Mifepristone stops the pregnancy from growing. It blocks the body from producing the progesterone hormone, which is necessary for a pregnancy to continue. Without progesterone, the pregnancy will end. 
  2. Misoprostol, taken 1–2 days later, induces cramping and bleeding to cause the uterus to empty.

In cases when mifepristone may not be available, taking a misoprostol-only regimen may still be effective.

Your doctor may also prescribe pain medication or recommend over-the-counter (OTC) pain medication to take with the abortion medication. Acetaminophen (Tylenol) and ibuprofen (Advil) are both safe to take with a medication abortion. However, do check with your doctor before you take any pain drugs — especially if they have prescribed any additional medications. 

Follow-up care

You will need to keep in close contact with your doctor if you have any complications. Medication abortions also require a follow-up appointment to ensure that the pregnancy termination went as expected.

Typically, your follow-up appointment will take place about a week after you take the abortion pills. 

Often, the follow-up appointment can be completed through a telehealth visit. Your doctor may want you to confirm that you are no longer pregnant by asking you to use a home pregnancy test or ordering blood work.

How effective is the abortion pill?

The abortion pill is very effective. In the first 9 weeks of pregnancy, medication abortion that consists of 200 milligrams of mifepristone and 800 micrograms of misoprostol has a success rate of 95–98% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source .

According to KFF — formerly known as the Kaiser Family Foundation, a nonprofit organization that is not affiliated with Kaiser Permanente — the success rate of medication abortion up to 9 weeks gestation is 99.6%.

However, the effectiveness drops progressively from weeks 9 through 11. In these cases, doctors may recommend additional dosing of misoprostol.

Who can use the abortion pill?

Specific laws around abortion policy, including requirements for receiving a medication abortion, vary by state.

There are currently no age restrictions for medical abortions, but some states do have restrictions based on gestation. Talk with your OB-GYN about abortion laws in your state to learn about your options.

To learn about potential changes to abortion access, here are some questions to ask your OB-GYN.

Risk groups for medication abortion

Your doctor may recommend medication abortion as an option for induced abortion or to remove a pregnancy after a miscarriage. However, there are some situations when a medication abortion is not an option.

The American College of Obstetricians and Gynecologists explains that doctors may recommend a surgical abortion if:

  • You have an ectopic pregnancy.
  • You have an intrauterine device (IUD).
  • You have a condition that requires long-term steroid therapy.
  • You have chronic adrenal failure.
  • You use blood thinners.
  • You have an allergy to mifepristone or misoprostol.
  • You have anemia.

Talk with your OB-GYN about your individual risk factors to determine the safest and most effective care for you.

How do you get the abortion pill?

The abortion pill is not available over the counter. A doctor must prescribe it. In some states, the prescription can come from another health professional, such as a physician’s assistant or nurse practitioner.

Some doctors may be able to prescribe a medical abortion through a telehealth visit.

State restrictions

Some states have restrictions on medical abortions, which may include the following:

  • Medical abortions are not allowed after a certain point in the pregnancy.
  • Only doctors can prescribe abortion pills, not other types of healthcare professionals.
  • Doctors must prescribe — and in some states, administer — medication abortions in person, not via telehealth.

Check with your doctor about any specific laws pertaining to medication abortions in your state.

What are the possible side effects and complications of the abortion pill? 

A medication abortion removes some of the risks associated with a surgical abortion, including possible damage to the uterus and cervix. However, a medication abortion still has possible side effects that can include:

Even when a medication abortion is effective in ending the pregnancy, certain complications can develop, including:

  • the pregnancy contents not passing fully
  • infection
  • heavy bleeding or hemorrhaging 

If the pregnancy contents did not fully pass, you might require surgery to remove any remaining pregnancy contents. 

Serious complications of a medication abortion

Misoprostol is a medication known to cause congenital anomalies Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source when someone takes it in the first trimester. Some doctors may inform the person of the risk of a congenital anomaly if the medical abortion does not work or if the person changes their mind about finishing the abortion. 

Severe complications from a medical abortion are rare, but they require immediate treatment if they occur. Contact your OB-GYN right away if you have symptoms such as:

Only 0.2% of people who have a medical abortion will need medical assistance within 24 hours of the abortion. 

How long does recovery take with the abortion pill?

You can resume your typical activities as soon as you feel able to after a medical abortion. Recovery can be as quick as a few hours to a few days after you have taken both medications. 

You can also resume your desired contraceptive almost immediately after a medical abortion. You may even be able to start some options the same day as the medication abortion.

After a medical abortion, you may have a higher risk of losing a future IUD. Talk with your OB-GYN about this risk if you are interested in having an IUD at a later point.

Learn more about popular types of birth control.

How does the abortion pill affect future pregnancies?

Research suggests Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source that abortion — either medication or surgical — does not affect someone’s ability to get pregnant in the future, nor does it increase their likelihood of future pregnancy complications.

Most people will experience their menstrual cycle returning in 4–6 weeks after a medication abortion. Because ovulation occurs before someone’s period begins, it is possible to get pregnant before your period returns. 

Other frequently asked questions

These are some other questions that people often ask about the abortion pill. Alexandra Perez, Pharm.D., M.B.A., BCGP, has reviewed the answers.

Do abortion pills damage the womb?

Abortion pills will not damage the womb. In rare situations, there may be a risk of damage if some parts of the pregnancy remain inside the uterus or if the uterus becomes infected.

How much do abortion pills cost?

Planned Parenthood, a nonprofit organization that provides abortion care, reports that the abortion pill can cost up to $750. Talk with your doctor and insurance provider about your specific coverage and potential out-of-pocket costs. You may also be able to find financial assistance through a local health clinic.  

Is the abortion pill the same as Plan B?

The abortion pill is not the same as Plan B, or the “morning after” pill. Plan B is an emergency contraceptive that you can take within 72 hours of having sex without contraception. It works by blocking ovulation and fertilization to prevent pregnancy from occurring. It does not end a pregnancy.

Summary

The term “abortion pill” actually refers to two medications that, when taken as prescribed, can end a pregnancy. A medication abortion is a safe, noninvasive method of pregnancy termination.

A medication abortion is very effective. More than half of early abortions in the U.S. are medication abortions.

Talk with your doctor about laws in your state regarding access to medication abortions. Also, discuss your individual risk factors to determine if medication abortion is the right option for you.

Was this helpful?
21

Medical Reviewer: Alexandra Perez, PharmD, MBA, BCGP
Last Review Date: 2022 Jun 24
View All Pregnancy Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.