Remember this information is useful for abortion with pills in pregnancies that are 10 weeks or less counted from the first day of your menstrual period. If you are more then 10 weeks pregnant we are not trained to support you but we will do our best to refer you to an organization that is.
The combination of Mifepristone and Misoprostol is very effective (95%)
You will need 1 pill of Mifepristone and 4 pills of Misoprostol. The Mifepristone pill should be 200 mg (or the equivalent to 200 mg) and each Misoprostol pill should be 200 mcg. If possible, it is good to have 8 Misoprostol pills total (4 extra) just in case you need them.
If the pills you are getting have different dosages of mg and mcg, you will need to recalculate so you can get and use the correct amount of medication.
If you have any questions or something is not clear to you, please do not hesitate to contact us. We are here to support you throughout your abortion process.
How to use Mifepristone and Misoprostol?
Step 1: Swallow the Mifepristone pill with water.
If you throw up in the first hour (60 minutes) after swallowing Mifepristone, it is likely that the pill will not work.
Step 2: Wait 24-48 hours after swallowing Mifepristone.
You may choose to wait 24 hours, 48 hours, or anywhere inbetween this time frame. There is no difference in regards to the effectivity, so you may choose within that time frame what is most convenient for you.
Step 3: Take 800 mg of Ibuprofen 1 hour before using Misoprostol.
This step is not required, but we highly recommend it. Ibuprofen will reduce the intensity of the cramps and help you manage the possible side effects of Misoprostol such as headache, fever and chills.
Step 4: Place 4 Misoprostol pills under your tongue (sublingual).
It is very important that the pills remain under your tongue for 30 minutes. In these 30 minutes the pills will be absorbing into your system. After 30 minutes you may drink water to wash down what remains of the pills.
If you vomit during the 30 minutes that the Misoprostol pills are under your tongue, it is likely they will not work. In this case, it is necessary to immediately repeat step 4. If you vomit after the pills have been under your tongue for 30 minutes, there is no need to repeat step 4 as the pills have already absorbed into your system.
If 3 hours have passed since you used Misoprostol and you have not had any bleeding or the bleeding has been lighter than your normal period, the best thing to do is use more misoprostol. You do not need to use extra Misoprostol pills if you started bleeding like your period or more within 3 hours after using the first 4 pills.
(Step 5): Place 2 pills of Misoprostol under your tongue. They must remain there for 30 minutes. Wait 3 hours.
(Step 6): If you still have no bleeding or it is very light 3 hours after step 5, you can use 2 more Misoprostol pills the same way you have been using them before.
If 3 hours pass and you still have no bleeding or cramping, contact us. We do not recommend you use more pills until we can evaluate together the situation.
After taking Mifepristone, the majority of women do not have any visible symptoms, meaning they do not feel anything. If you happen to bleed after taking Mifepristone, it is still very important that you use Misoprostol in order for the procedure to work.
After using Misoprostol you will experience cramping and bleeding. Some women (not all) will expel blood clots as well. Consider it is not possible to know exactly when the pain and bleeding will start – it could be right after you use Misoprostol or some hours later.
The expected bleeding should be the same amount as your menstrual period or more for several hours. Consider that the abortion takes about 2 weeks to complete itself. This means that you can continue to bleed on and off for various days or even weeks after using the pills.
Remember that each abortion experience is different and the symptoms can vary from woman to woman.
The majority of women who have pregnancy symptoms stop having them approximately 5 days after using Misoprostol. If your pregnancy symptoms start to dissapear and go away after using the pills, this is a good sign that you are no longer pregnant.
After using Misoprostol, some women experience side effects that can last for a some hours or a few days. These side effects include:
- nausea / vomiting
To avoid hemorrhaging and/or infection, it is important that you take the following precautions until your bleeding completely stops:
- avoid introducing objects in your vagina, including tampons and the menstrual cup
- avoid intense physical activity (exercising, carrying, pushing or pulling heavy objects, walking more than normal, or walking up too many flights of stairs)
If you have one of the following symptoms, this is considered a warning sign that you might be experiencing a complication and you should immediately seek medical attention :
- If you fill two pads or more (completely soaked front to back, side to side) in 1 hour or less and this last for 2 hours or more.
- A fever of 38 degrees Celsius (100.4 degrees Fahrenheit) that does not decrease after taking Ibuprofen. (If you think you have a fever always confirm with a thermometer.)
- A fever of 38 degrees Celsius (100.4 degrees Fahrenheit) that does not decrease 12 hours after using Misoprostol. (If you think you have a fever always confirm with a thermometer.)
- Pain that does not get better after taking Ibuprofen.
- The color or smell of your blood is very different from your regular period or has a bad smell.
- If you have redness, itchiness or swollen hands, neck and face it is likely you are having an allergic reaction to the medications. You can use an antihistaminic, but if you find it difficult to breathe then the allergic reaction is very serious and you need medical care immediately.
- “Safe abortion: technical and policy guidance for health systems.” World Health Organization.
- “Clinical updates in reproductive health.” Ipas.
- “Providing medical abortion in low-resource settings: An introductory guidebook. Second edition.” Gynuity.
- “Clinical policy guidelines for abortion care.” National Abortion Federation (NAF).
- “Induced Abortion.” American College of Obstetrics and Gynecologists.
- “Care for Women Choosing Medication Abortion.” The Nurse Practitioner.