How Do I Know If My Medication Abortion Worked?And What Follow-Up Is Needed
Medication abortion — often using mifepristone followed by misoprostol — is highly effective, especially in the first 12 weeks of pregnancy. Most people complete the process safely at home without any complications. But it’s common to wonder: How do I know if it worked?
What to Expect After Taking the Pills
Bleeding & Cramping: Most people pass the pregnancy within 4–6 hours after taking misoprostol, but it can happen sooner or take up to 24 hours. You can expect heavy bleeding with clots — often heavier than a period — followed by lighter bleeding for up to two weeks.
Tissue Passage: You may pass small clumps or tissue. Some people notice a grayish sac, but not everyone sees this.
Symptom Changes: Pregnancy symptoms like nausea, breast tenderness, or fatigue often improve within a few days, though hormones can take 1–2 weeks to settle.
Signs the Abortion Was Likely Complete
Bleeding and cramping that gradually decrease over a few days
Pregnancy symptoms going away
A negative pregnancy test 4–5 weeks after taking the pills
When to Suspect It Might Not Be Complete
Little to no bleeding within 24 hours after taking misoprostol
Bleeding stops and then heavy bleeding or strong cramps start again days later
Ongoing pregnancy symptoms (like nausea or breast tenderness) beyond 1–2 weeks
A positive pregnancy test 5 weeks after the abortion (some tests can stay positive for a few weeks even after a complete abortion, so timing matters)
When to Get Medical Help Right Away
Heavy bleeding: Soaking more than 2 maxi pads an hour for 2 hours in a row
Severe pain not improving with ibuprofen
Fever over 100.4°F (38°C) lasting more than 24 hours
Feeling weak, dizzy, or faint
You can say you think you’re having a miscarriage. There is no blood or urine test that can detect abortion pills. In the U.S., doctors are legally required to treat you.
Follow-Up Options
Not everyone needs an in-person follow-up, but some people prefer it for peace of mind. Common follow-up options include:
Self-assessment: Monitoring your symptoms and taking a home pregnancy test at 4–5 weeks.
Telehealth check-in: Some providers offer a phone or video follow-up.
In-person visit: An ultrasound or blood test (hCG levels) can confirm the abortion is complete.
Helpful Hotlines
M+A Hotline: 1-833-246-2632 — For medical questions about abortion pills
Reprocare Healthline: 1-833-226-7821 — For emotional support and guidance
Bottom line: Most medication abortions work without any complications, but knowing what’s normal — and when to get help — can give you peace of mind. You don’t have to go through this alone, and support is available every step of the way.
