A medical abortion ends an early pregnancy by using a combination of medicines. It’s a safe procedure that works by stopping the growth of the pregnancy and then causing the uterine lining to shed. The mifepristone and misoprostol regimen can be used up through 12 weeks for an at-home abortion.
A medical abortion (or medication abortion) is a procedure that uses prescription pills to end a pregnancy in the early stages. The most common regimen involves taking two pills — mifepristone and misoprostol. Mifepristone blocks progesterone, the hormone needed to support a pregnancy. Misoprostol causes cramping and bleeding to empty your uterus.
A medical abortion is a nonsurgical way to terminate a pregnancy in the first trimester. If you’re beyond the first trimester, your provider may discuss procedure options with you. Terms for procedure abortions are in-clinic abortion, aspiration abortion and dilation and curettage (D&C) abortion.
Having a medical abortion is a highly personal decision based on your own circumstances. Someone may choose to have a medical abortion because they’re concerned about passing along a congenital or inherited disease. Some may want to end an unwanted pregnancy. Providers sometimes use the same pills to treat a miscarriage that hasn’t expelled yet, known as a missed abortion. Your provider might refer to this as completing a miscarriage. A medical abortion may also be an option if carrying the pregnancy could be life-threatening.
Everyone’s situation is different. Reaching out to a healthcare provider who understands your medical history and healthcare needs can help as you weigh your options.
The Federal Drug Administration (FDA) has approved the use of mifepristone and misoprostol for medical abortion as safe and effective up to 10 weeks of gestation, but there’s evidence that it’s safe and effective beyond 10 weeks of gestation. FDA regulations allow certified medical professionals and pharmacies to distribute the medications for medical abortion in healthcare settings and by mail. Access by mail makes it possible for people receiving care via telehealth to receive their medications.
Laws governing abortion vary by state. State laws determine whether it’s legal for a person to receive a medical abortion in that state. In states where medical abortions are legal, state law governs:
As with any procedure, it’s important to discuss your medical history with your healthcare provider to ensure it’s safe. A medical abortion isn’t a safe option if you:
Over half of all abortions performed in the United States are medical abortions. This means that most people who choose to terminate a pregnancy do so in the early stages.
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You’ll meet with a healthcare provider for an evaluation. While the specific steps depend on the state where you’re having the procedure, preparation may involve:
A medical abortion involves taking pills by mouth or through your vagina. First, you’ll take mifepristone to end the pregnancy. Then, you’ll take misoprostol to empty your uterus. Follow the instructions as prescribed.
Most people start to feel the most effects from the medicine shortly after taking the second pill (misoprostol). You can expect:
A medical abortion takes about two to six hours after you’ve taken the second pill, although it may take longer in some cases. Plan to rest during this time. It’s a good idea to have someone you trust with you so they can provide care and comfort.
A medical abortion feels most like strong period cramps. The intensity of the cramping and pain are different from person to person. You can use a heating pad and take most over-the-counter (OTC) pain relievers to help. Most people use NSAIDS, such as ibuprofen.
Ask your healthcare provider which medications you should take to manage pain, and when you should take them. For example, it may be a good idea to take a pain reliever half an hour before taking the misoprostol.
Vaginal bleeding and cramping are the biggest side effects. While the heaviest bleeding typically occurs several hours after taking the second pill, you may have period-like bleeding for several days afterward. You may have light to moderate bleeding for several weeks.
You should also expect to have a follow-up visit or call with your healthcare provider to ensure the pregnancy ended.
The amount of bleeding varies from person to person. It also depends on how far along you were in your pregnancy. Expect heavier bleeding for one to two days. Bleeding will typically lessen over two to three weeks. You may need to wear sanitary pads until the bleeding stops. Using pads helps you see clots and gauge blood loss so you can share this information with your provider.
Your healthcare provider will want to talk to you or see you for a follow-up appointment within two to five weeks. Your provider may ask that you take a home urine pregnancy test, complete lab work, or have an ultrasound to confirm that the medication worked and you’re no longer pregnant.
A medical abortion is a safe and effective way to end an early pregnancy. With a medical abortion:
Medical abortions are considered safe and effective. Complications are rare. But it’s important to take all medications as prescribed. Skipping a dose or not following instructions can pose health risks.
Risks of a medical abortion include:
There are no long-term health risks associated with medical abortion.
When using the combination of mifepristone and misoprostol, it’s about 98% effective. It’s a safe and effective way to end a pregnancy.
Recovery times vary. Most people start feeling better the day after taking the last pill. You may be able to resume normal activities within a day or two. Pay attention to your body and take it easy if you need to. Avoid any activities that cause you pain.
Recovery isn’t always just physical. You may feel a range of emotions — from relief to sadness, stress or guilt. These feelings are normal. It may be helpful to speak with a mental health professional, like a therapist, about how you’re feeling. If you need help processing, ask your provider for recommendations on mental health professionals who can provide support.
Wait at least two to three weeks to have intercourse after a medical abortion. This is to prevent vaginal infections. You shouldn’t insert anything into your vagina during this time, including tampons.
You’ll be able to get pregnant again within two weeks after the abortion. Your normal menstrual cycle should return within four to six weeks after a medical abortion — although your first period may be slightly irregular because of hormonal changes related to the procedure.
Medical abortion shouldn’t affect future pregnancies unless there were complications.
Work closely with your healthcare provider throughout the process of your medical abortion. Ask any questions you have to ensure you understand what’s involved during the procedure and after.
Contact your healthcare provider if any of the following occur afterward:
A note from Cleveland Clinic
Medical abortions are a safe and effective way to end a pregnancy. The decision to have one is highly personal. If you need this procedure, know that you’re not alone in the process. Your healthcare provider can guide you so you understand exactly what’s involved before, during and afterward. They can connect you with resources you may need to process any emotions you’re feeling throughout the experience. Your healthcare team is there to make sure you’re comfortable and receiving the care you need.
Last reviewed by a Cleveland Clinic medical professional on 01/16/2024.
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