You’ve probably heard of medical abortion (also known as “Plan C,” “the abortion pill,” chemical abortion, or medication abortion). It’s a method of pregnancy termination using medication rather than surgery.
Maybe you’ve heard of it; maybe you’ve experienced it.
As you navigate this decision, it is important to make thoughtful and informed decisions regarding your reproductive health. So it’s necessary to understand the procedure, how it works, and the risks and side effects.
“The Abortion Pill”: What Is It?
One of the most common terms people use for medical abortion is “the abortion pill,” but that’s a bit of a misnomer. It’s actually two sets of medication and multiple pills.
Medication abortion uses two different medications, mifepristone and misoprostol, to terminate an early pregnancy. Abortion medication is FDA-approved through 10 weeks gestational age. It is unsafe to take abortion pills if you are beyond 10 weeks of pregnancy, have an ectopic pregnancy, or have certain medical conditions such as bleeding disorders or severe adrenal failure. Additionally, if you are allergic to the medications used in the process or do not have access to emergency medical care, it is advised to avoid taking the pills.
Mifepristone & Misoprostol: How Do They Work?
Mifepristone, the first medication in a chemical abortion, works by blocking progesterone (a hormone necessary for the pregnancy to continue) to the pregnancy, causing the lining of the uterus to break down. This stops the blood supply to the fetus, resulting in the termination of the pregnancy.
Misoprostol, taken 24 to 48 hours later, induces uterine contractions, expelling the pregnancy tissue. This feels like intense cramping and bleeding as the pregnancy tissue passes. For your health and safety, it is imperative to follow up with a provider on day 7-14 to ensure that the abortion is complete. If the abortion was incomplete, a curettage (surgery) or another dose of misoprostol may be administered to complete the process.
What Will I Feel During & After the Procedure?
While everyone’s abortion experience is different, be aware that it can be extremely painful.
At its mildest, medical abortion may feel similar to a heavy menstrual period. After taking misoprostol, you may experience cramping, vaginal bleeding, and the passing of large blood clots as the body expels the pregnancy tissue.
The intensity of these symptoms varies greatly from person to person. For some, the physical pain is as intense as childbirth. You must have access to emergency medical care during the process in case complications should arise. (Complication risks are serious. A 2015 California-based study of over 54,000 abortions showed the complication rate for medical abortion was 4 times higher than that of surgical abortion.)
Other common adverse reactions include:
- Nausea, weakness, fever/chills, vomiting, headache, diarrhea, and dizziness
- Abdominal pain/cramps
- Anxiety, fainting, and palpitations
Women should expect bleeding for 9 to 16 days, with heavy bleeding for an average of 2 days. Some women experience bleeding for more than 30 days.
After 8 weeks gestation, when expelled from the uterus, the fetus may be visible when passed, which can cause emotional trauma. Even without seeing the fetus, abortion can be an emotionally traumatic experience, especially if it was a coerced decision or one you felt unsure about.
Many women have expressed surprise at how painful their experience was, both physically and emotionally. Research shows that 34% said their outlook on themselves or their decision changed negatively since their abortion(s), and 63% of women reported they could have benefited from talking to someone after their abortion(s).
No one can tell you how you “should” feel after an abortion. If you’re feeling grief and relief at the same time, it can be confusing. But you don’t have to deny any of your feelings–it’s common to feel contrasting feelings after a complex experience of loss. Find a safe space to process and heal. If you’re interested in attending one of our drop-in abortion healing groups for emotional support, fill out this form and someone will reach out to you.
Are Medical Abortions Safe?
Medical abortions, while commonly considered safe and effective, come with serious potential risks and side effects. Risks increase when abortion pills are utilized without proper health screening beforehand. Certain pre-existing health conditions and other circumstances must be ruled out while determining a person’s eligibility for the medication. These include (1):
- Ectopic pregnancy (a pregnancy outside the uterus)
- Allergies to the medications used (mifepristone and misoprostol)
- A pregnancy past 10 weeks gestation (gestational age is most accurately determined via ultrasound)
- Use of long-term corticosteroids
- An IUD in place
- A blood clotting disorder, significant anemia, or chronic adrenal failure
- No access to emergency care
The possibility of complications rises when medication abortions are self-managed without the supervision of a healthcare professional. Make sure you get an ultrasound before your medication abortion. At Clearway, we offer free ultrasounds to verify gestational age and other necessary information as you make your pregnancy decision. Schedule your appointment today.
Due to the real risk of serious and sometimes fatal infections or bleeding, the FDA determined that only certain providers are approved to prescribe abortion medication. For your health and safety, NEVER purchase abortion pills online from an unknown source. The possibility of this being an unverified provider poses a great risk to your health.
Some serious risks of medication abortion include:
- Severe bacterial infections and sepsis, with or without fever, that may result in death
- Severe hemorrhage requiring surgical intervention or transfusion
- Prolonged heavy bleeding that may indicate incomplete abortion or other complications
- Ruptured ectopic pregnancy
- Rupture of the uterus
- Allergic reaction (anaphylaxis)
Take your health seriously! If you are considering the abortion pills, make sure you have the proper health screening beforehand and are well-informed on all your options.
What If I Changed My Mind?
Abortion is a complex decision. Some people consider abortion due to financial challenges, others for relationship complications, education goals, timing, lack of support… the list goes on (2). Oftentimes, multiple challenges compound upon each other.
Many of these reasons share in common a sense of, “I can’t do this,” or perhaps, “I can’t do this right now.” That’s not an easy situation to be in, and it can feel incredibly disempowering to think you have to choose abortion to be okay.
Sometimes, during the abortion process, a person might realize this isn’t really what they want. If that moment occurs before an abortion procedure begins, there’s time to get resources and seek support. If you’ve already started your chemical abortion, there’s actually still a small window of time where you can change your mind.
As explained above, medical abortion consists of two sets of medication. If you have already taken mifepristone, the first medication, you still have time to reverse the abortion process, but you have to act fast.
Abortion pill reversal uses natural progesterone to reverse the effects of mifepristone, the first abortion medication that blocks progesterone to the pregnancy. Studies have shown a ⅔ success rate for saving pregnancies treated with oral progesterone, with no apparent increase in birth defects (3).
Natural progesterone has been used for over 50 years in the treatment of early pregnancies in women at risk of miscarriage. Progesterone is also used in women who have conceived with in-vitro fertilization (IVF). There are no known increased risks of birth defects from ingesting natural progesterone.
From the time mifepristone is taken, a woman has about 72 hours to change her mind. However, it’s best to call within 24 hours. If you want to reverse the abortion, do not take the second medication, misoprostol. Misoprostol, if taken, is associated with birth defects. Contact the Abortion Pill Reversal hotline to be connected with a doctor near you.
Making An Abortion Decision
If you’re considering abortion, you have the right to make an informed decision. We’re here to help you do that.
- Take advantage of our free medical services, which include free pregnancy testing, STI testing, and ultrasound.
- We also offer free telehealth consultations, during which a nurse can determine, based on your health history, if you are in need of some medical services prior to scheduling an abortion procedure. Your nurse can also provide information on all abortion procedures and answer any questions you may have.
- Meet with a Clearway advocate to receive a customized resource referrals list to help you combat any obstacles you are facing in regards to this pregnancy. We’re here for you with compassionate support and guidance as you make your decision.
You are not alone. Chat with us to schedule your consultation today!
Reviewed by Deana G., BSN RN
- https://my.clevelandclinic.org/health/treatments/21899-medical-abortion
- https://www.guttmacher.org/journals/psrh/2005/reasons-us-women-have-abortions-quantitative-and-qualitative-perspectives
- 2018 observational study: A case series detailing the successful reversal of the effects of mifepristone using progesterone: https://pubmed.ncbi.nlm.nih.gov/30831017/
