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The Abortion Pill: How It Works & Side Effects

Over the last few years, the abortion pill (also called “Plan C”) has become the most popular form of abortion. But how exactly does it work? How much does it hurt? What are the side effects? Does it work? Is it safe to get it online?

Here at A Woman’s Choice, we want women to feel empowered to make positive choices for their future, and we believe the first step to confidence is knowledge. In this article, we’ll walk through everything you need to know about the abortion pill. If you have questions or concerns you’d like to discuss with a caring advisor, please reach out to us! 

Table of Contents

How does the abortion pill work?

Early Pregnancy Termination

The abortion pill is made for women who are up to 10 weeks pregnant (70 days after the first day of your last menstrual period).1 For women’s health and protection, the pill is currently approved for use only with the prescription and oversight of a licensed doctor.

Before the pill can be prescribed, a patient will visit a doctor to receive some screening and medical testing to determine if she is eligible to take the pill, including:

Pregnancy testing and ultrasound: Doctors must determine exactly how far along her pregnancy is. This can be done through an ultrasound at a healthcare clinic or a free testing provider like A Woman’s Choice. 

Birth control screening: If the patient has an intrauterine device (IUD), it will have to be removed before beginning the abortion pill regimen. 

STD/STI Testing: STI testing is strongly recommended prior to an abortion, due to risk of severe complications if the abortion pill is taken while a patient is infected. 

High risk screening: Some health conditions put women a high risk for serious complications from a medical abortion. A doctor will evaluate patients’ medical history to determine if there are any concerns.

Questions or concerns about the abortion pill?
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How the Abortion Pill Process Works

Although it’s called the abortion pill, a medical abortion is actually a series of several pills. The first step in the process is to take a medication called mifepristone (also called by its brand name Mifeprex). This medication is a single pill that blocks progesterone to stop a pregnancy from growing. This step terminates the pregnancy, but the process is not over yet because the pregnancy still has to be removed.

The second medicine is called misoprostol. This medication consists of four tablets that are taken at home up to 48 hours after the first pill. It will soften the cervix and cause significant cramping and heavy bleeding to expel the pregnancy. After taking both medications, the pregnancy is typically ended and usually passed from the uterus within 2 to 48 hours.

Following the abortion, patients must return to their doctor two weeks later to have an exam or ultrasound to confirm that the abortion was completed, and check for signs of infection or other complications.2 The entire abortion process usually takes about two weeks from start to finish. If the abortion pill didn’t work properly, additional doctor’s visits will be needed.

Watch this video to see a quick overview of how the Abortion Pill works

Can I get the abortion pill online or over the counter?

You might have seen the abortion pill advertised online, but according to the FDA, the majority of those pills are not legal and might be ineffective, counterfeit, tainted, and unsafe.2,3 And unlike Plan B (also called “the morning after pill”), it’s not available over the counter.

While some women prefer to take the abortion pill because they feel it will be more comfortable to have their abortion at home, the oversight of a doctor is still vital. A medical abortion is not an option for women who can not make follow-up visits to their doctor or don’t have access to emergency care.

READ: The Abortion Pill Online: How to Know What's Legitimate & Keep Yourself Safe

Does the abortion pill hurt? What are the side effects?

Abortion Pill Symptoms

The level of pain from the abortion pill varies from woman to woman, but there are expected symptoms that nearly everyone will experience. Heavy cramping and bleeding is the primary symptom, with 80%–90% of women reporting they bleed more heavily from the abortion pill than they do during a heavy period. 

These other common symptoms can last for 2 to 4 weeks after the abortion5:  

  • Abdominal pain and cramping
  • Extended spotting and bleeding
  • Nausea
  • Vomiting
  • Fever
  • Chills
  • Diarrhea
  • Headache

Abortion Pill Side Effects

Most of these symptoms can be managed from home with prescription and over-the-counter medications (doctors usually prescribe anti-nausea and painkillers with the abortion pill). However, there are some less common side effects that mean a patient needs to see the doctor as soon as possible 6,7: 

  • Heavy or persistent bleeding – soaking two or more pads an hour for two hours
  • Passing clots for two or more hours that are larger than the size of a lemon
  • Severe abdominal or back pain
  • Fever above 100.4
  • Fever lasting more than 24 hours
  • Foul-smelling vaginal discharge
  • Continuing symptoms of pregnancy

Mental & Emotional Side Effects of the Abortion Pill

One thing many women are often unaware of is that there are emotional side effects which are actually more common than the physical effects. While physical symptoms can be relatively immediate, many women experience emotional and psychological effects that may appear later and last longer—everything from mild regret to more serious complications like depression.

The American Pregnancy Association, says that the common negative feelings include:

  • Guilt
  • Anger
  • Shame
  • Remorse or regret
  • Loss of self-esteem or self-confidence
  • Feelings of isolation and loneliness
  • Sleep problems and bad dreams
  • Relationship problems
  • Thoughts of suicide8

 

“In addition, some people may experience grief, stress, or a sense of loss and may feel less able to cope. If suicidal thoughts or self-harm occur, the person should seek urgent help.”

In most cases, these negative feelings will subside as time passes. However, if there are additional issues, such as a sense of isolation or previous history of mental health problems, there may be a higher chance of depression occurring.9

Is the abortion pill safe and effective?

The abortion pill is about 98% effective at ending a pregnancy (depending on how early it’s taken).10 But, as with all things, there are risks and it is important to be aware of them. Sometimes, the pill won’t work and with all serious procedures, things can go wrong. 

The worst-case scenarios:

  • Serious side effects requiring medical intervention, including bacterial infection (which can be fatal), excessive bleeding, vomiting, diarrhea, fever, and severe cramping.
  • Hemorrhage and infection are the leading cause of abortion-related disease and death from mifepristone.11
  • The Food and Drug Administration (FDA) has received reports of 24 mifepristone-related deaths of women and 97 ectopic pregnancies since 2000, when the drug was approved. More than 750 women have been hospitalized, more than 400 women have experienced blood loss requiring transfusions, and 308 had infections requiring treatment.12
  • Fatal toxic shock is possible following chemical abortions with mifepristone and misoprostol.13
  • Allergic reaction causing anaphylactic shock.14

 

The rate of abortion-related ER visits following a medical abortion has risen dramatically in the last several years, so it is important to be aware of the risks. Abortions should never be administered without medical supervision.

If you experience complications from the abortion pill and need to seek medical attention, do not be afraid to let healthcare professionals know that you have taken the abortion pill. It is important for them to have all the information about your situation in order for them to give you proper care and ensure your safety. Many times, women report they are having a miscarriage because they are afraid to tell doctors they have taken an abortion pill, but this only puts patients at further risk for complications.

How much does the abortion pill cost? Is it cheaper than a surgical abortion?

The total cost depends on factors that are different in each woman’s situation, but in Florida the average cost for a medical abortion is between $500 and $62515. Although surgery sounds more intimidating, the abortion pill method can actually be more expensive than a surgical procedure ($350-$62516), will take longer, and will require multiple medical appointments. If there are complications requiring surgery, that is not included in this cost.

cost of the abortion pill and related expensees

There are also other things that you may need to pay for before and after taking the pills, such as:

  • The initial doctor visit
  • Blood work and a pregnancy test
  • An ultrasound to see how far along the pregnancy is
  • IUD removal if one is in place
  • Prescription medication such as antinausea meds, pain meds, and antibiotics
  • STD testing/treatments if there’s risk
  • Stocking up on heavy duty menstrual maxi pads
  • A follow-up doctor visit
  • Follow up ultrasound


Depending on how long the effects last, patients may also need to take time off work or line up childcare for other children.

Have a Conversation with Someone Who Cares

The abortion pill is a big decision with lots of questions surrounding it, but it doesn’t have to be navigated alone. At A Woman’s Choice, we’d love to answer any question you have about abortion, pregnancy, and pretty much anything about your sexual health.

Chat with us anonymously online, book an appointment for a free consultation and medical testing, or contact us just to talk privately about what you’re facing if you or a friend are pregnant.

Free Abortion Pill Consultation

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Other FAQs

A Woman’s Choice does not prescribe the abortion pill or refer for abortions. We are a non-profit community organization that is here to offer free education, medical testing, and support to women facing unplanned pregnancies. Learn more about our services here.

The abortion pill must be prescribed by a healthcare care professional who is licensed to distribute it. In prescribing the abortion pill, doctors must follow the abortion regulations of the state in which they are licensed. 

In Florida, abortion is legal up until the 15th week of pregnancy, which includes the abortion pill up to 10 weeks of pregnancy. Women seeking the abortion pill will have to first visit a provider’s office to receive an ultrasound and counseling, and fulfill a 24-hour waiting period before the pill can be prescribed.(9) Click here for more information on Florida’s abortion requirements.

Plan B (also known as the morning after pill) is not the same as the abortion pill. Plan B is an over-the-counter form of emergency contraception that is designed to prevent pregnancy and will not end a pregnancy that has already been conceived. For more information on Plan B, click here.

Plan C is another name for the abortion pill, ru486. Plan B (also known as the morning after pill) is not the same as the abortion pill. Plan B is an over-the-counter form of emergency contraception that is designed to prevent pregnancy and will not end a pregnancy that has already been conceived. For more information on Plan B, click here.

Unlike Plan B, the abortion pill is not available over the counter and should only be administered by a licensed abortion provider.

It is possible to buy the abortion pill online, however the purchase of this medication without the supervision of a licensed health provider is illegal and increases the risk of getting medication that is ineffective, counterfeit, tainted, or unsafe. The risk of complications is also higher when an abortion is administered without the supervision of a doctor. Click here for more information about buying the abortion pill online.

The FDA says:

Do Not Buy Mifeprex or its Approved Generic Over the Internet

You should not buy Mifeprex or its approved generic over the Internet because you will bypass important safeguards designed to protect your health.

Mifeprex and its approved generic have special safety restrictions on how it is distributed to the public. Also, drugs purchased from foreign Internet sources are not the FDA-approved versions of the drugs, and they are not subject to FDA-regulated manufacturing controls or FDA inspection of manufacturing facilities.[2]

According to recent studies, women who take the abortion pill are at a 53% greater risk of an ER visit for an abortion-related reason compared to ER visits following a surgical type of abortion. The rate of abortion-related ER visits following a medical abortion increased 507% from 2002-2015.16

The abortion pill may be taken up to 10 weeks of pregnancy, or 70 days after the first day of your last menstrual period. For pregnancies past 11 weeks gestation, a surgical procedure would be required for abortion.17

You may ovulate one to two weeks after a medical termination of pregnancy, meaning it’s possible to become pregnant again prior to your next period.

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A Woman’s Choice does not perform or refer for abortion procedures. For specific information about our services, refer to the site above.