Considering the Abortion Pill? Get the Facts First

When facing an unplanned pregnancy, it’s crucial to have accurate, complete information about all your options. If you are considering the abortion pill, it is important to know how it works. You should also understand its risks and what to expect. This knowledge can help you make an informed decision.

How Does the Abortion Pill Work?

The abortion pill consists of two different medications: mifepristone and misoprostol. This two-drug regimen works by interrupting the pregnancy process and causing the uterus to expel the developing embryo.

First Medication: Mifepristone

Mifepristone is taken first, usually in an abortion clinic. This medication reduces the amount of the hormone progesterone to the embryo. This hormone helps keep the pregnancy going. Without it, the embryo stops growing.^[1]

Progesterone is essential for preparing and maintaining the uterine lining that supports the developing embryo. Without a steady supply of progesterone, the embryo stops growing and eventually dies.^[2]

Second Medication: Misoprostol

Misoprostol is taken 24-48 hours after mifepristone, often at home. This medication causes the uterus to contract and cramp. This helps it expel the fetus and pregnancy tissue, ending the pregnancy.^[3]

What to Expect When You Take the Abortion Pill

Here’s a typical timeline for the abortion pill:

1. Mifepristone is taken first, followed by misoprostol 24–48 hours later.
2. Cramping and bleeding start within 2-24 hours of taking misoprostol.^[4] For most women, this process finishes within a day, but it can take longer for some. Everybody is different, so the exact timing varies.^[5]
3. Bleeding can begin as early as 2 hours after taking misoprostol.^[6]
4. Heavy bleeding may last a few hours, with lighter bleeding or spotting for 9–16 days. In some cases, spotting can continue for up to a month.^[7]

Frequently Asked Questions

How does the abortion pill work?

A: The abortion pill is a two-medication process involving mifepristone and misoprostol.

Mifepristone is taken first to reduce progesterone, which stops the embryo from growing. Misoprostol is taken 24-48 hours later to cause uterine contractions and expel the pregnancy tissue. The entire process typically takes place over several days.

Can I get the abortion pill without a prescription or order it online?

No. In order to take the abortion pill, you must have a prescription from a certified provider.

The FDA strongly advises against ordering abortion pills online from uncertified sources, as these may be counterfeit, expired, improperly stored, or contain unknown ingredients that could lead to serious health complications.

Why do I need an ultrasound before considering the abortion pill?

An ultrasound is crucial for several safety reasons:

• It confirms the pregnancy (since home tests can sometimes give false results).
• It determines accurate gestational age (the abortion pill is only FDA-approved up to 10 weeks).
• It rules out miscarriage and ectopic pregnancy (which cannot be treated with abortion pills and is life-threatening).
• It identifies other potential complications that may affect treatment options.

What are the warning signs that require emergency medical care?

• Seek emergency care immediately if you experience:
• Heavy bleeding (soaking through two pads hourly for two hours or more).
• Ongoing severe symptoms lasting longer than 24 hours after taking misoprostol (severe stomach pain, fatigue, nausea, vomiting, diarrhea).
• Fever of 100.4°F or higher for more than 4 hours. These could indicate serious complications like infection or incomplete abortion.

What free services does Crossroads Care Clinic offer?

We provide free pregnancy tests, ultrasounds, a safe and non-judgmental environment to explore your options, and resource connections for additional support services.

All services are confidential and free of charge. Please note that we do not provide or refer for abortion services, but we are dedicated to providing accurate information to help you make an informed decision.

Have a question? Let us know!

Other Related Articles

Sources

1. FDA. (2025, February 11). Questions and Answers on Mifeprex. U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifeprex
2. See source #1.
3. See source #1.
4. U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html
5. Mayo Clinic. (2025, February 1). Mifepristone (oral route). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123
6. See source #4.
7. See source #4.
8. Mayo Clinic. (2022, July 29). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
9. See source #1.
10. Fjerstad M, Sivin I, Lichtenberg ES, Trussell J, Cleland K, Cullins V. Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days. Contraception. 2009;80(3):282–286. https://pmc.ncbi.nlm.nih.gov/articles/PMC3766037/
11. See source #4.
    
12. Shin, Hyun Joo, et al. “Anaphylactic Shock to Vaginal Misoprostol: A Rare Adverse Reaction to a Frequently Used Drug.” PubMed Central (PMC), 9 Aug. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6137020
    
13. FDA. (2019, July). Prescribing Information for Mifeprex. U.S. Food & Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/022348s014lbl.pdf
14. See source #8.
15. See source #4.
16. Center for Drug Evaluation and Research. (2025, January 17). Mifeprex (Mifepristone). U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information
17. See source #16.
18. See source #16.
19. Indiana Department of Health. (2023, August 22). Guidance Regarding the Regulatory Implementation of Senate Enrolled Act 1 – 2022 (ss). IN.gov. https://www.in.gov/health/cshcr/files/SEA1-Regulatory-Guidance-2023-Aug-22.pdf