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Medical abortion is carried out via the vagina or by taking a combination of abortion pills orally. It works by halting the pregnancy’s development and inducing uterine lining shedding. However, it can be done as soon as you find out you are pregnant.
There are two main ways abortion can be done: the abortion pill (also called medication abortion) and an abortion procedure (also called in-clinic abortion). Whether you have a medication abortion or an abortion procedure will depend on how far along you are in pregnancy, what the provider you choose offers, and also your own preference. We have more information about how to decide between these two types of abortion.
The abortion pill is generally available earlier in pregnancy. Each provider will have their own rules about how far along in pregnancy they’ll offer it–some will offer it through 13 weeks of pregnancy and others will stop offering it much earlier in pregnancy. Later on in pregnancy, your only option will be the abortion procedure.
You can get abortion pills from most in-person abortion providers. Depending on what state you’re located in, you may also be able to get abortion pills online using telehealth.
The first medication is called mifepristone. Mifepristone blocks the hormone progesterone. Because progesterone is necessary for pregnancy to continue, blocking it starts the process of ending the pregnancy. Mifepristone doesn’t usually cause any symptoms, so you probably won’t feel anything after you take it. Your provider may have you take the mifepristone at the health center, or you may take it at home.
Your provider will give you the second medication. Usually, you’ll get it when you get the mifepristone, but you may have to go back to the provider to get it. Make sure to follow the instructions the provider gives you because they may differ from one provider to the next.
Up to 48 hours after taking mifepristone, you’ll take a dose (which is usually four tablets) of the second medication, called misoprostol.
For this step, you need to be somewhere you can relax and where you’ll have easy access to a bathroom. Misoprostol empties your uterus, expelling the pregnancy. It causes cramping and bleeding.
There are a few different ways to take misoprostol: you can take it orally, by swallowing the pills; you can take it vaginally, by putting the pills inside your vagina; you can take it sublingually, which means that you place the pills under your tongue and let them dissolve; or you can take it buccally, which means putting the pills in your mouth between the inside of your cheek and your gum and letting them dissolve there.
You may take one or more doses of misoprostol depending on how far along you are and how your body responds to the first dose—your provider will let you know. Misoprostol starts working about 30 minutes to a few hours after you take it. When it kicks in, it’s normal to experience bleeding. The bleeding could range from medium to very heavy. You will likely pass some blood clots. You’ll also likely have cramps, which can be severe. You may experience diarrhea or vomiting, and you may also have a mild fever on the day you take the misoprostol.
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