medication abortion
Medication abortion is a method of ending a pregnancy using prescribed medications rather than a surgical procedure. It is commonly done in the first trimester (up to 10-12 weeks of pregnancy) and typically involves taking two different drugs: mifepristone and misoprostol.
Here’s how it works:
STEP 1
Mifepristone
The first pill, mifepristone, blocks the hormone progesterone, which is necessary for the pregnancy to continue. Without this hormone, the lining of the uterus breaks down, ending the pregnancy.
STEP 2
Misoprostol
The second medication, misoprostol, is taken 24-48 hours later, usually at home. It causes the uterus to contract and expel the pregnancy tissue, similar to a heavy period. Cramping and bleeding typically begin within a few hours.
This method is over 95% effective when used within the first 10-12 weeks of pregnancy. It is a safe option with few serious risks, though side effects like cramping, nausea, diarrhea and heavy bleeding are common during the process.
A follow-up visit or ultrasound is not necessary to ensure the abortion is complete. You can simply take a home pregnancy test 4-5 weeks after taking the pills to ensure it is negative. And if not, please follow up with a clinician.
THE BENEFIT
You can self manage it in the comfort of your own home
Less invasive
Telehealth visits are available and as of now, medication can be mailed to you discreetly
Still accessible in states with abortion bans due to shield laws
Lower cost
THE DOWNSIDE
The further along you are, the more painful it is to pass the pregnancy.
Can fail or require multiple doses
The waiting game for it to happen
Some people experience extended bleeding duration
Nothing’s changed just yet, but there are efforts to ban Mifepristone. For now, though, Mifepristone is still widely available, and the combo of Mifepristone and Misoprostol is still the go-to for medication abortions.
Mifepristone is routinely used through 12 weeks of pregnancy. Some organizations have suggested medication abortion can be used beyond that window in an effort to expand access, since it is the most accessible option for patients. While the goal is to increase availability of care, using abortion pills later in pregnancy can lead to a more painful, prolonged, and difficult experience and may carry higher risks. It is important to approach recommendations beyond 12 weeks with caution and to ensure people receive clear, accurate counseling about what to expect.
MISOPROSTOL-ONLY ABORTION
If mifepristone becomes unavailable or isn't accessible, a medication abortion can still be safely done using misoprostol alone. Misoprostol causes the uterus to contract and expel the pregnancy tissue. This method typically involves taking multiple doses of misoprostol (often 2-3 doses every 3-12 hours) until the abortion is complete. While it is slightly less effective than the combination of mifepristone and misoprostol (85-95% effective), it remains a safe and widely recommended option, especially in areas where mifepristone is restricted.
The Upsides:
Misoprostol is more widely available, affordable, and easier to access in many parts of the world.
Like the two-drug method, it can be self-managed at home and mailed discreetly in many cases.
The Downsides:
It may take longer to complete the process, and more doses may be required.
Cramping and bleeding can be more intense for some people.
Organizations like the World Health Organization endorse misoprostol-only abortions as a safe alternative. For legal questions or support, the Repro Legal Helpline is a trusted resource (844-868-2812).
Note about Misoprostol Route
Some people choose to take misoprostol by mouth instead of vaginally because small pill fragments can remain visible for a few days after vaginal use. This can matter for anyone who lives in a state with abortion restrictions or who is worried about discrimination or misunderstanding if they need emergency care. Oral misoprostol leaves no trace in the body and cannot be detected by any test, and the symptoms of a medication abortion are medically the same as a miscarriage.
Need pills or clinic info? These trusted resources can help:
Ineedana.com – Simple, fast clinic and telehealth search with clear information about cost, availability, and travel support in your area.
PlanCPills.org – A great resource for abortion pills by mail. Offers up-to-date telehealth provider listings, pricing comparisons, shipping timelines, and privacy guidance for all 50 states.
AbortionFinder.org – A comprehensive national directory of verified abortion providers, including clinics across the country.
It is worth noting: There are many companies that will ship abortion pills by mail. Many people are ordering abortion pills online from all states. Healthcare providers are able to mail to all 50 states, by using "shield laws" and having a license in the state they practice in. This shield law protects the provider. You may still face legal risks by accessing pills by mail in your state. For help with legal questions we recommend the Repro Legal Helpline at 844-868-2812.
