When you’re faced with an unplanned pregnancy,  it’s important to know all of your options. One of these options is the abortion pill.

In this guide, we’ll help you understand what the abortion pill is, what risks and side effects it carries, and how it works to terminate a pregnancy.

What is the abortion pill (RU486)?

Though we call it the abortion “pill,” a chemical abortion is actually a process that requires two types of medication. 

The first is mifepristone, which is the medication typically called the abortion pill. It is also known as RU486 or by its brand name, Mifeprex. The second medication is misoprostol, or Cytotec. According to the FDA, these medications can only be used for abortions through the first 70 days or 10 weeks of a pregnancy.

How does the abortion pill work?

You will start the chemical abortion process by taking mifepristone by mouth, usually at a doctor’s office, abortion clinic, or at home.

Mifepristone blocks a hormone known as progesterone. During the first 10 weeks of pregnancy, your ovaries produce a lot of progesterone to tell your uterus to prepare for the embryo and prevent your menstrual period.

Blocking progesterone tricks your body into thinking it’s no longer pregnant. The uterus stops feeding the embryo through the umbilical cord and begins to shed its lining, much like it does during your period.

About 24-48 hours after taking mifepristone, you will then take the second part of the abortion pill regimen. Misopristol is either ingested by mouth or inserted into the vagina. This medicine helps your uterus shed its lining and dilates your cervix, inducing cramping and heavy bleeding.

Most women continue to bleed for a few weeks after getting a medication abortion.

abortion pill

What happens after you take the abortion pill?

The most common side effects from the abortion pill are bleeding and nausea, sometimes severe enough to require anti-nausea medication from your doctor.

After taking misoprostol, you will continue to experience cramping and heavy bleeding. Many women have compared it to a miscarriage. You may also experience vomiting and diarrhea.

As the medication takes effect and your uterus empties, you will typically pass large blood clots, sometimes up to the size of a lemon, as well as the fetus or embryo. It’s important to prepare yourself mentally and emotionally for this process, especially if you are eight weeks along or later.

What are the risks and side effects of the abortion pill?

Like all medications, there are some major and minor side effects and risks that come with the abortion pill. You should always see a doctor before and after getting an abortion to prevent these serious issues.

Ectopic pregnancy

In 1 to 5% of pregnancies, the embryo implants outside of the uterus. If the embryo is not quickly removed through surgery and the pregnancy ruptures, you can suffer severe side effects, including death. Using the abortion pill with an ectopic pregnancy may terminate the pregnancy, but it cannot remove the embryo. Instead, according to the FDA, you may develop a severe blood infection, known as sepsis, from the embryonic tissue. Sepsis is deadly, causing tissue damage, organ failure, and for 250,000 Americans every year, death. Getting an ultrasound before taking the abortion pill is the only way to identify an ectopic pregnancy.

Incomplete abortions

There are two ways that the abortion pill regimen may fail.

First, it may not successfully terminate the pregnancy, even though you experience the typical side effects such as cramping and bleeding. If you are still pregnant, you will then need to have an additional surgical abortion.

Second, misoprostol doesn’t always successfully empty your uterus. In some cases, your body won’t fully expel the embryo or fetus. If this fetal tissue remains in your uterus, as sometimes happens during a miscarriage, you may develop sepsis. You will have to have surgery, typically either surgical aspiration or dilation and curettage (D&C), to finish the abortion.

Unusual bleeding

While heavy bleeding is expected, you could hemorrhage during a chemical abortion. Unusual and serious bleeding may include:

  • Bleeding through two regular-sized sanitary pads per hour for more than two hours
  • Passing clots larger than a lemon
  • Passing blood clots for more than two hours

If you experience any of these symptoms, you will need to contact your doctor or medical services immediately.

If you don’t have any bleeding within the first 24 hours after taking the second medication, you should contact a medical professional.

    side effects

    Serious infection

    During a medication abortion, some women have developed an infection and died of sepsis related to the procedure. Some signs of a serious infection include:

    • Nausea
    • A fever of 100.4°F or higher for longer than four hours
    • Stomach pain
    • Weakness

    If you experience any of the symptoms, you should contact your doctor or medical services immediately.

    Additional side effects

    Along with bleeding, cramping, and nausea, the most common side effects from the abortion pill include:

    • Diarrhea
    • Dizziness
    • Mild fever
    • Stomach pain
    • Tiredness

    What should I do before taking the abortion pill?

    If you are interested in a medication abortion, the first thing to do is to schedule an ultrasound. While the date of your last menstrual period provides a good idea of when you got pregnant, it isn’t always accurate. 

    An ultrasound allows a medical professional to measure the fetus, a more accurate way to see how far along you are in your pregnancy. You can then know if you are eligible for the abortion pill. An ultrasound will also show if you are experiencing an ectopic pregnancy. 

    It’s also critical to talk with a trusted medical professional about the process, side effects, and risks of taking these pills to abort your pregnancy. If you have existing medical conditions, talk with your doctor about potential complications and risks. This is a major life decision, so make sure you have all of the abortion information and answers you need.

    Can I change my mind after taking the abortion pill?


    Yes, you can stop and reverse a medical termination after taking the abortion pill. If you have only taken mifepristone and change your mind about ending your pregnancy, please call a medical professional through the Abortion Pill Rescue Network at 1-877-558-0333. They will help you reverse the abortion pill.

    This process requires a high dose of progesterone, which replaces the natural hormone that is being blocked by the abortion pill. It can only work within the first 24 hours of taking mifepristone and before taking misoprostol.

    How can I get the abortion pill?

    You can only get a chemical abortion from a certified healthcare provider. The FDA does allow you to get the abortion pill by mail, but you must speak to a medical professional first, often through a telehealth appointment.

    Most importantly, never use an abortion pill that you receive from anyone other than a certified healthcare provider. You can buy pregnancy termination pills online, but they may not be FDA-approved medications. Some abortion pills that are available online are created in foreign countries and not subject to reliable safety standards.

    Even if you are getting the medication from clinics that do abortions, make sure the person prescribing the pills is a certified healthcare provider.

    Frequently asked Questions (FAQ)

    What do the abortion pills cost?

    In Florida, chemical abortion prices are typically around $500, though you may pay up to $750. Your healthcare coverage may also affect the costs of your doctor’s visits, ultrasound, and the medication. If the abortion is unsuccessful or you need further medical assistance, you may have additional costs as well.

    Does the abortion pill prevent STDs?

    No, the abortion pill will not prevent or treat STDs. If you are concerned that you have an STD, consider getting STD testing to diagnose your illness and begin treatment.

    Facing an unplanned pregnancy? You’re not alone. Make an appointment today to get a free ultrasound, no-cost STD testing, and a chance to talk with someone about all of your options.

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