What to Expect When You Take the Abortion Pill

Facing an unplanned pregnancy can feel like a lot to handle. You might be considering the abortion pill as an option, but it’s important to know what’s involved. This medical process has risks and side effects you should understand before deciding.

This guide explains how the abortion pill works, what to expect during and after, and when to call a doctor. Knowing the facts helps you make a choice that’s right for you. Keep reading to learn more.

How Does the Abortion Pill Work?

The abortion pill, also called medication abortion, involves two drugs: mifepristone and misoprostol. Here’s how they work^[1]:

• Mifepristone: Taken first, this drug blocks progesterone, a hormone needed to keep a pregnancy going. Without it, the pregnancy cannot continue.

• Misoprostol: Taken 24–48 hours later, this drug causes the uterus to contract and expel the pregnancy tissue.

The FDA approves the abortion pill for pregnancies up to 10 weeks (about 70 days from your last period).^[2] 

Before taking the abortion pill, it’s important to receive an ultrasound to check how far along you are and to rule out issues like miscarriage or ectopic pregnancy (when the embryo is outside the uterus)—neither of which are treated by abortion.

How Long Does the Abortion Pill Take to Work?

Here’s a typical timeline for the abortion pill:

1. You take mifepristone, usually at a clinic or doctor’s office. You take misoprostol at home, 24–48 hours after mifepristone.^[3]

2. Cramping and bleeding start within 2-24 hours of taking misoprostol.^[4] Period-like bleeding can last up to a month.^[5] However, everybody is different, so the exact timing varies.^[6]

How Much Bleeding Is Normal After an Abortion?

The further along you are, the heavier the bleeding might be. Here’s what to expect:

• When it starts: Bleeding usually begins 2–6 hours after taking misoprostol.^[7]

• How long it lasts: Heavy bleeding may last up to 24 hours, with lighter bleeding or spotting for 9–16 days. As mentioned above, bleeding can continue for up to a month.^[8]

• When to call a doctor: If you’re soaking through two full-size pads per hour for two hours or more, call your doctor right away. This could signal a problem like hemorrhaging.

The abortion pill generally causes heavier bleeding than a surgical abortion.^[9] While some bleeding is expected, excessive amounts signal a need for medical attention.

Abortion Pill Side Effects

Like any medical procedure, the abortion pill has side effects. Common side effects include^[10]:

• Cramping

• Bleeding or spotting, which can last up to a month

• Nausea or vomiting

• Diarrhea 

• Headaches

• Chills or low fever

Serious risks of the abortion pill include:

• Allergic reaction: If you’re allergic to misoprostol ingredients, you could experience anaphylactic shock, a life-threatening condition.^[11]

• Hemorrhaging: Soaking two full-size sanitary pads per hour for two or more hours indicates excessive bleeding requiring urgent care.^[12]

• Incomplete abortion: If pregnancy tissue remains in the uterus, emergency surgery might be necessary to prevent infection.^[13]

• Infection: Persistent nausea, vomiting, diarrhea, or a fever lasting over 24 hours after misoprostol could signal an infection needing antibiotics or surgery.^[14]

When to Call Your Doctor

Pay attention to your body during and after the process. Call your doctor immediately if you notice^[15]:

• Heavy bleeding: Soaking through two pads hourly for two hours or more.

• Persistent sickness: Severe abdominal pain, weakness, nausea, vomiting, or diarrhea (with or without fever) lasting over 24 hours after taking misoprostol, potentially indicating infection or ectopic pregnancy.

• Fever: A temperature of 100.4°F or higher for more than 4 hours after taking misoprostol.

These signs could mean complications like infection or incomplete abortion, which need immediate medical treatment.

Have Questions About the Abortion Pill in Eastern CT? Contact The Women's Center of Eastern Connecticut.

An unplanned pregnancy can stir up fear, but you don’t have to let it control your decisions. At The Women's Center of Eastern Connecticut, we’re here to provide answers and resources for an informed, confident choice. 

Call or text us at 860-576-8072 or request your appointment online today. All services are confidential and free of charge! 

Please be aware that The Women's Center of Eastern Connecticut does not provide or refer for abortion services.

Sources

1. FDA. (2025, February 11). Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation?sm_guid=NTU1NzgyfDYzMDE1OTM2fC0xfGppbUBha2ZhbWlseS5vcmd8NTY4OTI4MXx8MHwwfDE5OTYwMDk4OHwxMDg2fDB8MHx8NTQ3NzI2fDA1

2. See source 1.

3. See source 1.

4. U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html

5. See source 4.

6. Mayo Clinic. (2025, February 1). Mifepristone (oral route). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123

7. See source 4.

8. See source 4.

9. Bridwell, R. E., Long, B., Montrief, T., & Gottlieb, M. (2022, October 23). Post-abortion Complications: A Narrative Review for Emergency Clinicians. The Western Journal of Emergency Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC9683756/

10. See source 4.

11. Shin, Hyun Joo, et al. “Anaphylactic Shock to Vaginal Misoprostol: A Rare Adverse Reaction to a Frequently Used Drug.” PubMed Central (PMC), 9 Aug. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6137020

12. Danco Laboratories, LLC & FDA. (2016, March). Mifeprex Label. FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf

13. Mayo Clinic. (2022, July 29). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687

14. See source 4.

15. See source 13.