How Do You Know If the Abortion Pill Worked?

The abortion pill is a simple way to end a pregnancy up to 11 weeks after the first day of your last period.

You can usually carry out part of the procedure at home, which can be more comfortable for some people.

But that can lead to anxiety about whether the pill has worked.

Although a follow-up appointment is the best way to get reassurance, there are a number of signs to look out for that point to abortion pill success.

How long does this process usually take?

The abortion pill comes in two separate doses. The process usually takes 1 to 2 days to complete.

You may experience symptoms for a few weeks after taking both pills.

You’ll first have an appointment with a nurse or doctor who will ask about your medical history and explain how the process works.

If you haven’t had a recent ultrasound, they will perform one to see how far along the pregnancy is.

How does it work?

A medical abortion uses two medications in the form of a pill to end a pregnancy.

Mifepristone is the first pill.

It blocks an important pregnancy hormone called progesterone. This results in the breakdown of the uterine lining and stopping the growth of the embryo.

The body soon realizes that the pregnancy can’t continue, so the second medication, misoprostol, helps the body push out the embryo through the vagina.

The body does this by causing the uterus to contract, which leads to a similar level of cramping and bleeding as a miscarriage.

How effective is it overall?

The abortion pill is highly effective, but its effectiveness does decrease the further along the pregnancy is.

What does it feel like?

Many liken the feeling of medical abortion to an early miscarriage.

After taking the second pill, you’ll likely experience abdominal cramps and heavy bleeding for a few hours.

Depending on how far along the pregnancy is, you may pass larger tissues that are brown or red in colour, and may be able to see the white pregnancy sac.

Misoprostol can also cause:

  • vomiting
  • diarrhoea
  • headaches
  • tiredness
  • fever-type symptoms

Look after yourself by staying in a comfortable place, whether that’s your own home or the home of family or friends.

If you can, take a couple of days off work so you can rest.

Lying down with a hot-water bottle on your abdomen can help relieve any pain. Some find sitting on the toilet to be a more comfortable position.

You’ll also need highly absorbent menstrual pads for the bleeding.

If you need pain medication, avoid aspirin, as it can worsen bleeding. Instead, take ibuprofen (Advil, Motrin). It may help to take pain medication around 30 minutes before the misoprostol.

If you feel that something isn’t right — especially if you’re soaking two or more pads an hour for a few hours or have a fever that lasts longer than a day — seek medical advice.

Hospitals and clinics don’t need to know you’ve taken the abortion pill if you feel unsafe telling them. Your symptoms mimic a natural miscarriage, so staff won’t be able to tell the difference.

How do you know when it’s over?

As soon as your abortion is complete, your symptoms should begin to reduce.

Bleeding may be lighter, while cramping may not feel so severe. Other side effects like fever or nausea should also disappear.

It may take a couple of days for you to get back into your normal routine, as the process can make you tired.

What if your provider says it didn’t work? What happens next?

Although the abortion pill is effective in the vast majority of cases, there’s a small chance that it may not work.

Your healthcare provider will be able to determine this at your follow-up appointment.

If you’re still pregnant, your healthcare provider will discuss other abortion options.

You may be able to take another dose of the abortion pill, or you may need a surgical abortion instead.

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