This article will address what to consider when self-managing an abortion with pills and how to best prepare for an abortion.
Preparing to use Misoprostol
When deciding when to have your abortion, keep in mind what other commitments or activities you have going on. The process can cause some uncomfortable side effects that are most prevalent in the first 24 hours. Even though you may feel fine after a day, you may want to schedule an extra day to rest and recover, just in case.
If you cannot take an extra day to rest, it is advisable to postpone all daily activities, at least on the day you plan to take the abortion pills. However, most people who are caring for others are not able to avoid their responsibilities. In these cases, it is advisable to ask for support from friends or family .
In addition to having a clear schedule, here are a few things you can do before using Misoprostol:
- keep hydrated;
- have Tylenol or ibuprofen on hand to help with the pain;
- avoid greasy or spicy foods;
- have pads on hand;
- have ginger ale or herbal tea ready for potential nausea;
- eat light meals; and
- keep a heating pad handy for cramping.
Depending on the protocol you are using, you might take Mifepristone and Misoprostol or just Misoprostol alone. If you are taking Mifepristone, you will take one pill that contains 200 mg of Mifepristone. If you are taking Mifepristone, you will take one pill that contains 200 mg of Mifepristone. Either method, you will take eight (8) or twelve (12) Misoprostol pills, each containing 200 mcg. Visit safe2choose for videos on how to administer Mifepristone and Misoprostol and how to administer Misoprostol only.
If taking Mifepristone, you will take one 200 mg Mifepristone pill first. Most people do not experience any side effects after taking Mifepristone, so you can go about your day-to-day activities. However, some people may experience some bleeding.
The next step is to take the first four Misoprostol 200 mcg pills. You should take Misoprostol 24 to 48 hours after the Mifepristone for optimal efficacy. You may take it sooner if you prefer, but you must take it within 72 hours of taking Mifepristone.
Routes of administration
There are several routes of administration when it comes to Misoprostol. For example, you can take it vaginally, in your cheeks (buccally), or under the tongue (sublingually). When you take the pills will depend on the route of administration you choose.
When deciding which method to use, consider these factors:
- If you feel nauseous, the vaginal route may be better.
- If abortion is restricted in your area, take Misoprostol via the cheeks or sublingually. Misoprostol may still be detectable in a pelvic exam for up to four days after administration. Thus, the cheek method is more discreet and won’t leave a trace.
At safe2choose, it is advised that you choose the oral or buccal route to administer Misoprostol, rather than vaginally, because traces of Misoprostol may still be detectable up to four days after administration. It’s strongly suggested that you have a look at your country’s abortion laws and restrictions carefully before using the vaginal route.
Take 800 mg of Ibuprofen and 1,000 mg of extra-strength Tylenol to help minimize cramping 30 minutes prior to taking Misoprostol. Empty your bladder prior to using the pills, too.
Start by washing your hands. You can lie down or squat to insert the tablets; however, do not insert them over the toilet. Insert all four tablets into your vagina with your finger, as far as you can comfortably go. Lie down for 30 minutes. Afterwards, you can move around as you please. You may see the pills or remnants of the pills. This is okay, as long as you allow the medication to absorb for 30 minutes.
Cramping and bleeding can start as early as 30 minutes to a few hours afterwards.
In the cheek
Take 800 mg of Ibuprofen and 1,000 mg of extra-strength Tylenol to help minimize cramping 30 minutes prior to taking Misoprostol. Take a sip of water to moisten your mouth. Then, place the four Misoprostol pills in between your cheek and gums, placing two on each side of the mouth. Let the pills sit in your cheeks for 30 minutes. After 30 minutes, swallow what remains of the pills.
If you vomit during the 30 minutes the Misoprostol is in your cheeks, seek counseling.
Under your tongue
Take a sip of water to moisten your mouth. Then, place the four Misoprostol pills under your tongue, and let them sit for 30 minutes. After 30 minutes, swallow what remains of the pills with water.
You may have access to extra doses of Misoprostol. You may need this second dose or you may not. If you experience minimal or no bleeding 24 hours after taking Misoprostol, take a second dose using the same route of administration. Additionally, if your pregnancy is longer than nine weeks, take a third Misoprostol dose within three hours using the same route.
For Mifepristone & Misoprostol regimen, it is strongly recommended to use eight pills of Misoprostol. If you can’t obtain eight Misoprostol pills, you may choose to proceed with only four pills, but the effectiveness will be reduced, especially if you are between 10-13 weeks pregnant.
For Misoprostol alone, it is strongly recommended to use 12 pills of Misoprostol. If you can’t obtain 12 Misoprostol pills, you may choose to proceed with only eight pills, but the effectiveness will be reduced, especially if you are between 10-13 weeks pregnant.
What to expect from Misoprostol
You will experience heavy bleeding and cramping after Misoprostol administration. You may also experience symptoms such as
- diarrhea, and
You can treat pain with up to 800 mg of ibuprofen and up to 1,000 mg of extra-strength Tylenol every six to eight hours, as needed. The dosage of painkillers should not exceed 3,200 mg over the course of 24 hours. For nausea, you can take 8 mg of ondansetron every six hours, as needed.
When to contact us
In certain situations, you should reach out to a counselor, over chat or email at safe2choose, to discuss the next steps. These situations include
- vomiting within 30 minutes of taking Mifepristone or while it’s in your cheeks (the pills won’t have had the desirable effect and you will need to repeat that step);
- serious pain that does not get better with painkillers;
- bleeding so much that you soak two full-sized pads in less than two hours;
- a high fever 24 hours after taking Misoprostol;
- blood clots larger than the size of a lemon;
- an allergic reaction; and
- no bleeding or clots within 24 hours of taking Misoprostol.