The abortion pill (drug-induced abortion) involves two medications— mifepristone and misoprostol.

Mifepristone blocks progesterone, which sustains early pregnancy. Misoprostol causes the uterus to contract and expel pregnancy tissue. The process typically occurs at home and can last several hours to several days.

Experiences vary widely; some women report moderate symptoms, while others experience severe cramping, heavy bleeding, or complications that require medical attention.

Review the information below. Confidential support is available if you have questions about the information presented.

HOW IT WORKS: STEP BY STEP

1
First dose: Mifepristone
Blocks progesterone and stops the pregnancy from progressing.
2
Second dose: Misoprostol (taken 24–48 hours later)
Triggers cramping and bleeding to expel pregnancy tissue.
3
Follow-up evaluation
A medical check is recommended to confirm the process is complete and to rule out retained fetal parts or infection.

Even though the steps seem straightforward, the physical process can be intense, and recovery times differ from person to person.

FDA CONTEXT & MEDICAL OVERSIGHT

The FDA approved mifepristone in 2000 with requirements for monitoring, distribution safeguards, and medical evaluation. Over the years, these guidelines have been adjusted and continue to receive national attention.

WHAT TO KNOW:

  • The FDA approves the medication for use up to 11 weeks of pregnancy.
  • The agency still advises confirming gestational age and ruling out ectopic pregnancy in person, due to the risk of missed diagnoses when the medication is obtained online.
  • Ongoing post-market surveillance has identified cases of incomplete abortion, severe bleeding, infection, and the need for surgical follow-up, prompting continued review of safety standards.
  • Expanded access through telehealth and mail-order pharmacies has increased debate about whether women receive adequate medical screening beforehand.

These considerations are especially important in states where access to abortion pills is legal but women may receive them from a range of providers, including online sources with limited oversight.

COMPARING IN-CLINIC AND
ONLINE PILL PROVIDERS

In-clinic oversight typically includes:

  • Ultrasound to confirm gestational age
  • Screening for ectopic pregnancy
  • Rh factor testing
  • Review of medical history and contraindications
  • Clear instructions on when to seek emergency care
  • Access to follow-up medical evaluation

Online pill providers may:

  • Rely solely on self-reported information
  • Provide little or no screening for ectopic pregnancy
  • Offer limited guidance on contraindications
  • Lack follow-up care if complications arise

Understanding these differences clarifies how care and oversight vary, especially since some complications require timely medical intervention.

IF YOU’VE TAKEN THE FIRST PILL,
YOU MAY HAVE OPTIONS

Abortion Pill Reversal (APR) is a treatment option for women who have taken the first medication of the abortion pill (mifepristone) and are seeking to continue their pregnancy. APR works by using progesterone, a natural hormone that supports early pregnancy, to counteract the effects of mifepristone.

APR is time-sensitive and is most effective when started within 24 hours of taking mifepristone, but there have been reported cases of success beyond that window. If you’re considering APR or want to learn more, talk with a medical professional to understand your options and whether this treatment may be right for you.

TALK TO A NURSE

APR Hotline: 877-558-0333

Learn the Facts

Every woman deserves accurate medical information and access to care. Understanding how the abortion pill works and the physical effects women report provides important medical context.
FIND LOCAL CARE

*SOURCES

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

Largest-Ever Study of Abortion Pill Reveals Shocking Number of Adverse Events.
https://www.revisor.mn.gov/laws/2023/0/Session+Law/Chapter/4/

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