Procedure, Effect, and Further Information on Medication Abortions
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Depending on local policies, chemical (i.e., medication) abortions are possible until the 9th week of pregnancy.
- The abortion pill is a combination of two medications:
- First, a single pill of 600mg mifepristone is taken (or 3x200mg pills). This medication causes the cervix to dilate and the uterine lining to loosen. The embryo dies in the process.
- Another medication (misoprostol) is taken 2-3 days later, causing contractions that bring about the expulsion of the embryo.
On this page, you will find more information about the process and effect of a medication abortion, including possible risks and side effects.
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Abortion With Pills
In addition to surgical abortion methods, medication abortions are possible through pills. This is also referred to as chemical or hormonal abortion. Here, abortion (removal of the embryo) is achieved by taking medication.
The abortion pill must be prescribed by a doctor and can be used until the 9th week of pregnancy.
Cut-off dates for abortions vary from state to state and country to country. However, there is no minimum length of pregnancy for the utilization of the abortion pill.
In this context, the word “pill” is a colloquial term for abortion pill.
ℹ️ Note: The drug used for an abortion contains a different active ingredient than the birth control pill or the morning-after pill.
What Kind of Pills Are Used for Abortion?
The abortion pill is a two-drug combination: The active ingredient of the first medication is mifepristone. In addition, prostaglandin pills, such as Cytotec® with the active ingredient misoprostol, are used to complete the abortion.
Prostaglandins are also sometimes used before surgical abortions via vacuum aspiration.In this case, the purpose of the drug is to soften the cervix in advance.
How Much Does the Abortion Pill Cost?
Privately funded, the abortion pill usually costs $350 to $650 in the US, 560 pounds in GB, $250 in Australia and R620-R1200 in South Africa. (Rates are not guaranteed.) For more information, go to How Much Does An Abortion Cost?
What Is the Abortion Pill and How Does It Work?
According to the Guttmacher Institute, the abortion pill was used in over 54% of US abortions in 2020. Mifegyne® is the most common abortion pill brand name. Other names for the abortion pill are Mifeprex®, Mifegymiso®, RU-486, and Mankind’s Unwanted Kit.
How the Abortion Pill Works:
- The abortion pill contains the active ingredient mifepristone. Mifepristone blocks the effects of the hormone progesterone, which is essential for maintaining a pregnancy.
- Mifepristone makes the pregnant woman's body believe she is no longer pregnant.
- Within approximately 48 hours, the cervix opens, and the mucus plug loosens.
- The preliminary stage of the placenta with the chorionic villi is already developing in the very first weeks of pregnancy. It is responsible for the exchange of nutrients and metabolic products between the maternal and child's circulation. Mifepristone causes the lining of the uterus with the chorionic villi to detach from the uterine wall. The embryo loses its source of nourishment and footing and dies.
- In rare cases (3%), the first abortion pill causes bleeding and cramping, resulting in the expulsion of the embryo and placental tissue.
- However, in most cases, the first pill (mifepristone) alone does not lead to the embryo's expulsion. Therefore, the doctor also administers a prostaglandin two to three days later. This is a hormone that triggers contractions.
Side Effects of the Abortion Pill
Aside from vaginal bleeding, a medication abortion can have the following side effects:
- Abdominal pain/cramps
- Dizziness, chills, or hot flashes
- Nausea, vomiting, and diarrhea
- Heavy bleeding
Heavy bleeding may necessitate a curettage or a blood transfusion. For this reason, a medication abortion should only be performed under medical supervision and near an emergency room.
Your doctor will provide you with further information during your preliminary consultation.
How Does a Medication Abortion Work?
The nine most important steps to take before an abortion can be found in the article "Abortion methods."
Before the Procedure
In some cases, the woman's blood type is determined. This is an advisable precautionary measure for two reasons:
- If heavy bleeding during the abortion necessitates a blood transfusion.
- If the woman is rhesus negative, she will need to receive a RhoGAM shot to avoid complications in future pregnancies.
Often, an ultrasound is ordered by the prescribing physician to determine the location and size of the embryo.
Taking the abortion pill while experiencing an ectopic pregnancy would mask the symptoms. This may cause a dangerous delay in medical intervention.
Ultrasound is the most accurate tool for determining how far along you are in the pregnancy. Once you have passed the 9th week of pregnancy, the risk of complications with the use of the abortion pill increases drastically. Therefore, most countries ban the abortion pill beyond the 9th week.
Medication Abortion Procedure
- Initially, the pregnant woman takes one 600mg pill of mifepristone (or 3x200mg). She should be under medical supervision for at least two hours after administration of the drug.
- Two to three days later, another medication with the active ingredient misoprostol is taken. Misoprostol is a synthetic prostaglandin that induces contractions. During an abortion, it causes the uterus to contract and bleed. For the next six hours, the woman should be closely monitored.
- Within approximately two hours after the administration of misoprostol, bleeding sets in, and the embryo is expelled. Should the bleeding have not commenced within three hours, a second dose of four misoprostol tablets is administered.
After the Procedure
Seven to twenty-one days after the administration of misoprostol, a follow-up examination is recommended. Ultrasound or lab tests can determine whether the embryo and placental tissue with the chorionic villi have been completely expelled.
If this is not the case, a second dose of medication or curettage may be necessary, resulting in additional costs.
Gentle or Stressful? - Possible Risks
At first glance, a medical abortion seems more manageable and less stressful for the woman — after all, the alternative would be surgery. Nevertheless, several aspects should be considered:
Potential Physical Side Effects
Terminating one’s pregnancy via the abortion pill, using mifepristone and misoprostol, is physically very demanding - causing hormonal imbalance and lasting several days.
- For further information on risk factors, go to Physical Effects of an Abortion.
Potential Emotional Side Effects
Additionally, women often experience significant emotional anguish:
- By taking the pill, the woman actively initiates the process of abortion.
- Many women still feel torn even after taking the first pill and struggle to decide whether they want to go through with the abortion. Then, the question arises of whether it is still possible to keep the baby. Sometimes it is too late to stop the abortion after taking mifepristone, but reversals are successful in many cases. For more information, go to Reversing an Abortion.
- Many women find it particularly hard to consciously experience an abortion that lasts several days.
To find out more, go to Anticipated Emotional Effects of an Abortion
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Where Do I Go From Here?
Perhaps you are pregnant, and this situation is very stressful for you. Maybe your pregnancy was unexpected and came at an inconvenient time. Your partner possibly doesn't want this child. You may already have several children and can’t imagine having one more.
You are not alone! Allow us to walk alongside you as you determine which path to take. Our judgement-free resources are tailor-made for you and your situation:
- ⛑ Unsure where to start? Take our First Aid Test!
- ⚖️ Wondering whether to have an abortion or not? Take the Abortion Test!
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