Since abortion pills were first FDA approved in the U.S. in 2000, there’s been a shift as more people started choosing medications (called a medical abortion) over surgical procedures to end a pregnancy. In fact, almost 40% of all abortions in 2018 were medical abortions — a 120% jump since 2009. but Side effects of abortion pills
While a medical abortion is a safe and effective way to terminate a pregnancy, it does carry some side effects and risks for the pregnant person. Cramping and bleeding are expected but can become a problem if severe or accompanied by other symptoms.
Read on to learn about what to expect with a medical abortion — side effects, risks, and more.
What is the abortion pill?
When we talk about the “abortion pill,” we’re usually referring to two medications — Mifepristone OK and Oklahoma Misoprostol — that are taken together to end a pregnancy.
This combination is also called a medical abortion, or medication abortion, and it’s FDA approved for use through 70 days gestation. This means that it can be used within 70 days (10 weeks) from the first day of your last menstrual period.
Some healthcare providers may prescribe these medications up to 11 weeks gestation. This regimen usually includes an extra misoprostol dose.
However, medical abortions aren’t for everyone. For example, you may not be eligible for one if your pregnancy is outside of your uterus (called an ectopic pregnancy), you have bleeding problems, or if you’re using an intrauterine device (IUD), among other reasons.
How does it work to end a pregnancy?
During the first 10 weeks of pregnancy, cells in your ovaries release a hormone called progesterone to prepare the lining of your uterus for pregnancy. This allows for the embryo to implant and begin to grow.
Mifepristone works by blocking the progesterone that’s needed to maintain a pregnancy. Misoprostol, on the other hand, works by causing the uterus to contract and the cervix to widen, allowing the pregnancy tissue to be pushed out of the body. safe abortion at home OK
How is it taken?
The pills are taken over the course of 2 to 3 days, starting with mifepristone. The FDA-approved regimen is as follows:
- Take 200 mg (1 tablet) of mifepristone by mouth on the first day. This is usually supplied by your healthcare provider, typically in a clinic, medical office, or hospital setting. Depending where you live, telehealth options might be available.
- Wait 24 to 48 hours, then take 800 mcg (four 200 mcg tablets) by inserting two tablets into each cheek pouch (the space between teeth and cheek). Hold the tablets in each cheek pouch for 30 minutes, then wash down anything that’s left with a glass of water.
- If you’re 71 to 77 days gestation, you’ll typically repeat the same misoprostol dose again 4 hours later.
After you’ve completed the medication regimen, you’ll need to follow up with your healthcare provider after about 1 to 2 weeks. Side effects of abortion pills
How long does the abortion pill take to work?
After you’ve taken both medications, it usually takes about 2 to 24 hours for the pregnancy to be removed from your body.
In some cases, you may still be pregnant or you haven’t completely passed all of the tissue from your body. This is why following up with your healthcare provider is important. If this is the case, they’ll discuss your options with you, which may include another medication dose or surgery.
What are the common side effects of the abortion pill?
A medical abortion can cause Side effects of abortion pills — especially after you take misoprostol. Side effects usually start within 2 to 24 hours of taking it.
It’s best to take misoprostol in a place where you feel comfortable and have everything you need. It might be a good idea to plan ahead and clear your schedule that day (and possibly the day after), if possible. Below are a few things to expect.
You should expect to experience cramping, especially after taking misoprostol. This is because it causes strong uterine contractions to help your body pass the pregnancy.
Your healthcare provider may recommend an over-the-counter (OTC) or prescription pain reliever to help you feel more comfortable, but you should avoid taking aspirin, since it can cause more bleeding.
You should also expect vaginal bleeding — sometimes heavier than your normal monthly bleeding — as the pregnancy leaves your body. It may also contain clots and tissue. Your healthcare provider may recommend that you use sanitary pads for a few days to keep track of your bleeding.
Together with cramping, these side effects usually mean that medications are working, but there are some exceptions that we’ll cover later. Although uncommon, some people may need to have surgery to stop the bleeding if it’s too heavy.
Over the next week or two, you may notice some bleeding or spotting — this is also normal. Sometimes it can even last up to a month. Because of this, you may need to wear sanitary pads during this time.
Side effects of abortion pills
Within the first 24 hours after taking misoprostol, you may experience some additional side effects, including:
- Fever or chills
However, if these side effects are severe or don’t go away, this could be a sign of something more serious — more on this next.
Are there any serious side effects or risks?
While side effects are expected after taking these medications, there are also a few serious side effects and risks to know about.
Even though medical abortions are very effective at terminating a pregnancy, sometimes they don’t work — even if you experienced the expected side effects. There’s a small chance that you may still be pregnant and require a surgical procedure to complete the process.
If the pregnancy continues without surgical intervention, there may be the potential for birth defects — but that risk is unknown. However, birth defects have been reported.
Heavy bleeding that requires surgery Side effects of abortion pills
Although bleeding is normal, there are certain situations that may require medical attention. For example, if you’re bleeding through two full-size sanitary pads every hour for at least 2 hours — or if you’re concerned about how much you’re bleeding — contact your healthcare provider right away.
In some cases, you may need to have a surgical procedure to remove anything remaining in your uterus. This is usually rare, affecting 1 out of every 100 people going through a medical abortion.
Surgical procedure options may include:
- Surgical aspiration: A type of surgical abortion that uses gentle suction to remove a pregnancy.
- Dilation and curettage (D&C): A surgical procedure that uses a scraping or suction tool to remove tissue from the uterus.
Blood clots in your uterus
As mentioned above, you may see some blood clots as you bleed. This is normal, unless they’re large (e.g., larger than a lemon) or you’ve been passing them for 2 hours or more. In this case, contact your healthcare provider right away.
If you’re feeling sick (e.g., nausea, stomach pain, weakness) — with or without fever — more than 24 hours after taking misoprostol, this could be a sign of something more serious, like an infection. In this case, contact your healthcare provider immediately. Similarly, call them right away if you’re experiencing a fever of 100.4°F or higher for more than 4 hours.
Although rare, there have been some reports of sepsis — a life-threatening response to an infection in your body. This is thought to be due to a certain toxin-producing bacteria found in the vaginas of about 10% of women.
You may not always develop a fever from a serious infection or sepsis after a medical abortion, so it’s best to pay attention to how you feel throughout the process and afterwards. As mentioned above, you should seek medical attention if you’re not feeling well more than 24 hours after taking misoprostol.
Ectopic pregnancies — pregnancies outside of the uterus — can’t be treated with a medical abortion. In fact, mifepristone shouldn’t be given to someone with a confirmed or suspected ectopic pregnancy for this reason.
As mentioned above, you shouldn’t have an IUD in place during a medical abortion — it needs to be removed before you take the medications. It’s also important to know that getting pregnant with an IUD in place raises the likelihood of an ectopic pregnancy.
Although your healthcare provider may perform tests in advance of a medical abortion, sometimes ectopic pregnancies are missed on an ultrasound. However, ectopic pregnancies in people obtaining medical abortions are rare, with 97 reported cases between 2000 and 2018.
Ectopic pregnancies can also cause a fallopian tube (a tube connecting the ovaries to the uterus) to rupture, leading to severe or life-threatening internal bleeding. And the symptoms you might experience — like stomach pain — can overlap with medical abortion side effects.
It’s important to seek medical attention right away if you experience sudden, severe stomach pain or shoulder pain, weakness, or fainting, as this could be a sign of a ruptured ectopic pregnancy.
Side effects of abortion pills
You may be wondering if there are any long-term effects of having a medical abortion. Perhaps you’re planning on getting pregnant again in the future, or you’re worried about other potential health risks. A few common concerns are discussed below.
Will taking the abortion pill affect my ability to get pregnant in the future?
Research has shown that having an abortion doesn’t raise your infertility risk. But if you’re unable to get pregnant later on, remember that infertility can be a complex issue and have several causes — resulting from either or both partners. You may want to see a fertility specialist to help pinpoint what’s going on and discuss your options.
You’re also able to get pregnant again right after a medical abortion. This means that you should be using preventative measures — like condoms or birth control — if you aren’t trying to get pregnant again right away.
Can having an abortion raise my breast cancer risk?
Since pregnancy has been shown to have some protective benefits against breast cancer in certain people, it’s thought that interrupting a pregnancy might raise your breast cancer risk. And while this theory has been studied for decades, current research doesn’t show this to be the case.