Facing an unplanned pregnancy can feel overwhelming. You may be trying to sort through a lot of information while carrying fear, uncertainty, and pressure about what to do next. If you are considering the abortion pill, you deserve clear, honest information about what the process involves before making a decision.
This guide walks through how the abortion pill works, what you may experience during and after, and when to seek medical care. Knowing what to expect can help you make a more informed choice.
How the Abortion Pill Works
The abortion pill, also called medication abortion, uses two medications: mifepristone and misoprostol. Here’s how they work[1]:
- Mifepristone: Taken first, this drug blocks progesterone, a hormone needed for pregnancy to continue. Without progesterone, the pregnancy cannot progress.
- Misoprostol: Taken 24–48 hours later, this drug causes the uterus to contract and expel the pregnancy tissue.
The FDA approves the abortion pill for pregnancies up to 10 weeks (about 70 days from your last period).[1]
Because timing matters, an ultrasound is strongly recommended before taking the abortion pill. An ultrasound confirms how far along you are and helps rule out miscarriage or ectopic pregnancy, which are not treated by abortion and require different medical care.
How Long the Abortion Pill Takes to Work
Here’s a typical timeline for the abortion pill:
- You take mifepristone, usually at a clinic or doctor’s office. You take misoprostol at home, 24–48 hours after mifepristone.[1]
- Cramping and bleeding start within 2-24 hours of taking misoprostol.[2] For most women, this process finishes within a day, but it can take longer for some. Everybody is different, so the exact timing varies.[3]
Bleeding After Taking the Abortion Pill
The further along you are, the heavier the bleeding might be. Here’s what to expect:
- When it starts: Bleeding usually begins 2–6 hours after taking misoprostol.[2]
- How long it lasts: Heavy bleeding may last a few hours, with lighter bleeding or spotting for 9–16 days. In some cases, spotting can continue for up to a month.[2]
- When to call a doctor: If you’re soaking through two full-size pads per hour for two hours or more, call your doctor right away. This could signal a problem like hemorrhaging.
The abortion pill generally causes heavier bleeding than a surgical abortion.[4] While some bleeding is expected, excessive amounts signal a need for medical attention.
Abortion Pill Side Effects and Risks
Like any medical procedure, the abortion pill has side effects. Common side effects include[2]:
- Cramping
- Bleeding or spotting, which can last up to a month
- Nausea or vomiting
- Diarrhea
- Headaches
- Chills or low fever
Serious risks of the abortion pill include:
- Allergic reaction: If you’re allergic to misoprostol ingredients, you could experience anaphylactic shock, a life-threatening condition.[5]
- Hemorrhaging: Soaking two full-size sanitary pads per hour for two or more hours indicates excessive bleeding requiring urgent care.[6]
- Incomplete abortion: If pregnancy tissue remains in the uterus, emergency surgery might be necessary to prevent infection.[7]
- Infection: Persistent nausea, vomiting, diarrhea, or a fever lasting over 24 hours after misoprostol could signal an infection needing antibiotics or surgery.[2]
When to Call Your Doctor
Pay attention to your body during and after the process. Call your doctor immediately if you notice[7]:
- Heavy bleeding: Soaking through two pads hourly for two hours or more.
- Persistent sickness: Severe abdominal pain, weakness, nausea, vomiting, or diarrhea (with or without fever) lasting over 24 hours after taking misoprostol, potentially indicating infection or ectopic pregnancy.
- Fever: A temperature of 100.4°F or higher for more than 4 hours after taking misoprostol.
These signs could mean complications like infection or incomplete abortion, which need immediate medical treatment.
Considering the Abortion Pill in San Diego, California? Contact CAPS.
An unplanned pregnancy can feel like a lot to carry, but you don’t have to face it alone. At CAPS, we offer free ultrasounds, accurate information, and a confidential space to ask questions and explore your options.
Our goal is to help you understand what is happening in your body so you can make a decision that protects your health and future.
Call us at (619) 337-8080 or book an appointment online today.
Get the Facts on the Abortion Pill at CAPS
You do not have to make this decision alone. You deserve to know every fact and every risk so you can make a confident and informed choice.
At CAPS, we are here to support you with free ultrasounds, consultations, and a nonjudgmental space to talk through your situation.
Call us at (619) 337-8080 or schedule your appointment online.
Please note that CAPS does not provide or refer for abortion services.
Sources
- 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
- U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html
- Mayo Clinic. (2025, February 1). Mifepristone (oral route). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123
- 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/
- 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
- Danco Laboratories, LLC & FDA. (2016, March). Mifeprex Label. FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf
- Mayo Clinic. (2022, July 29). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687