What to Expect When You Take the Abortion Pill: A Comprehensive Guide

Facing an unplanned pregnancy can feel overwhelming. If you’re considering the abortion pill, it’s important to understand how it works, what to expect, and the potential risks involved before making a decision.

This guide walks you through what you need to know before taking the abortion pill, how the process works, what happens during and after, possible side effects and complications, and when to seek medical care. Having accurate information can help you make an informed choice about your next steps.

What to Know Before Taking the Abortion Pill 

Before taking the abortion pill, several important medical steps are recommended:

1. Get an ultrasound. An ultrasound confirms how far along the pregnancy is and helps rule out conditions such as miscarriage or ectopic pregnancy (when the pregnancy develops outside the uterus). An ectopic pregnancy is a medical emergency that may require surgery. The abortion pill is ineffective on an ectopic pregnancy. 
2. Have a medical consultation. A qualified healthcare professional should screen you for conditions that make the abortion pill unsafe, including ectopic pregnancy, certain anemias, bleeding disorders, adrenal failure, long-term steroid use, an IUD in place, or allergies to the medications used.

• Test for Sexually Transmitted Infections. Untreated STIs like chlamydia or gonorrhea during abortion raise risks of pelvic inflammatory disease (PID). PID causes scarring that can lead to chronic pain, infertility, or ectopic pregnancies in the future.[1]

How Does the Abortion Pill Work?

The abortion pill—also called a medication abortion—uses two prescription drugs: mifepristone and misoprostol.[2]

• Mifepristone is taken first. It blocks progesterone, a hormone needed to sustain a pregnancy, causing the pregnancy to stop developing.
• Misoprostol is taken 24–48 hours later. It causes the uterus to contract and expel the pregnancy.

The FDA approves the abortion pill for pregnancies up to 10 weeks (about 70 days from your last period).[2]

How Long Does the Abortion Pill Take to Work?

While every woman’s experience is different, a typical timeline looks like this:

• Day 1: Mifepristone is taken, usually at a clinic or doctor’s office.
• 24–48 hours later: Misoprostol is taken at home.[2]
• Within 2–24 hours of misoprostol: Cramping and bleeding usually begin.[3]
• Afterward: Light bleeding or spotting may continue for 9–16 days, and in some cases up to 4 weeks.[4]

How Much Bleeding Is Normal After an Abortion?

Bleeding is expected with the abortion pill, but the amount can vary depending on how far along the pregnancy is.

• When bleeding starts: Usually within 2–24 hours after taking misoprostol.[3]
• How long it lasts: Heavy bleeding may last several hours, followed by lighter bleeding or spotting for up to two weeks or longer.[3]
• When to call a doctor: If you soak through two full-size pads per hour for two consecutive hours, seek medical care right away. This could indicate hemorrhaging.

Medication abortion typically causes heavier and longer bleeding than a surgical abortion.[5]

Abortion Pill Side Effects

Like any medical procedure, the abortion pill carries side effects and potential complications. 

Common side effects include[3]:

• Cramping
• Bleeding or spotting, which can last up to a month
• Nausea or vomiting
• Diarrhea 
• Headaches
• Chills or low fever

Serious Risks

• Allergic reaction: Rare but potentially life-threatening reactions, including anaphylaxis, can occur.[6]
• Hemorrhage: Excessive bleeding that requires emergency care.[7]
• Incomplete abortion: Retained pregnancy tissue may require surgery to prevent infection.[8]
• Infection: Symptoms such as persistent fever, foul vaginal odor, abdominal pain, nausea, vomiting, or diarrhea lasting more than 24 hours after misoprostol may signal infection.[3]

When to Call a Doctor

Pay attention to your body during and after the process. Call your doctor immediately if you notice[9]:

• Soaking through two pads per hour for two hours or more
• Severe or worsening abdominal pain
• Fever of 100.4°F or higher lasting more than four hours
• Persistent nausea, vomiting, diarrhea, weakness, or flu-like symptoms after misoprostol

These symptoms may indicate complications such as infection, hemorrhage, or incomplete abortion and require prompt medical care.

Considering the Abortion Pill in Cookeville, Tennessee? Contact Cookeville Pregnancy Clinic.

An unplanned pregnancy can bring fear and uncertainty, but you don’t have to face it alone. At Cookeville Pregnancy Clinic, we provide accurate information, medical-grade pregnancy services, ultrasounds, and compassionate support so you can explore all your options. 

Call us at (931) 526-5525 or book an appointment online today. 

Please be aware that Cookeville Pregnancy Clinic does not provide or refer for abortion services.

Frequently Asked Questions About the Abortion Pill

1. How painful is the abortion pill?
   Pain levels vary. Most women experience moderate to strong cramping similar to—or more intense than—a heavy period, especially after taking misoprostol.
2. Can you take the abortion pill at home?
   Misoprostol is typically taken at home, but prior medical screening, accurate ultrasound dating, and follow-up care are strongly recommended for safety.
3. Is the abortion pill safe without an ultrasound?
   An ultrasound is important to confirm how far along the pregnancy is and to rule out ectopic pregnancy, which can be life-threatening if untreated.
4. What happens if the abortion pill doesn’t work?
   If the abortion is incomplete or continues, additional medication or surgical intervention may be required to prevent infection or complications.
5. Are there alternatives to the abortion pill?
   Yes. Parenting and adoption are options many women consider, and support services are available to help you understand what each path could look like for you.

Sources

1. Mayo Clinic. (2022, April 30). Pelvic inflammatory disease (PID). https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
2. FDA. (2025, February 11). Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation?sm_guid=NTU1NzgyfDYzMDE1OTM2fC0xfGppbUBha2ZhbWlseS5vcmd8NTY4OTI4MXx8MHwwfDE5OTYwMDk4OHwxMDg2fDB8MHx8NTQ3NzI2fDA1
3. U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html
4. Danco Laboratories, LLC. (2022). MEDICATION GUIDE: Mifeprex. Danco Laboratories, LLC. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020687s014lbl.pdf
5. Mayo Clinic. (2025, February 1). Mifepristone (oral route). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123
6. Bridwell, R. E., Long, B., Montrief, T., & Gottlieb, M. (2022, October 23). Post-abortion Complications: A Narrative Review for Emergency Clinicians. The Western Journal of Emergency Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC9683756/
7. 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
8. Danco Laboratories, LLC & FDA. (2016, March). Mifeprex Label. FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf
9. Mayo Clinic. (2022, July 29). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687