|
Getting your Trinity Audio player ready...
|
How to take abortion pills: misoprostol & mifepristone
Abortion pills, known as medication abortion, are a safe and effective way to end a pregnancy. A huge benefit of abortion pills is that you can complete the abortion privately—and with telehealth providers like Nico Women’s Clinic, without leaving your home at all. Check out our pregnancy calculator to see how far along you are, and if pills are an option for you.
Learn how to take abortion pills vaginally, buccally (between cheeks & gums), or sublingually. Get step-by-step guidance on what to expect & how to manage symptoms.
Step 1: Swallow 1 Mifepristone pill with water
Swallow one mifepristone (200 mg) pill with water.
Most people feel fine after taking this pill. You can continue all of your regular activities. You may have some vaginal bleeding but may not — either is okay.
It’s unlikely, but if you throw up within the first 30 minutes after taking it, please contact your provider. If you throw up after 30 minutes, you don’t need to contact us because the medicine has been absorbed.
Note: If you’re been feeling nauseous with the pregnancy, you can take one ondansetron (anti-nausea) pill under your tongue and let it dissolve before starting Step 1. This medication is provided in your shipment from Nico Women’s Clinic
Step 2 prep: Decide how you want to take the misoprostol pills
You can take the second type of pill, misoprostol, several different ways: vaginally, buccally (between your cheeks and gums), and sublingually (under your tongue). All methods of taking misoprostol are equally effective, but can cause more nausea when taken sublingually (under the tongue) and the least nausea when taken vaginally.
How to take misoprostol vaginally
This method causes the least nausea because while pretty flavorless, the pills are very chalky and can be difficult to keep in your mouth for 20+ minutes if they are already feeling queasy during the pregnancy. However, this route might not be the best option if you have started bleeding as the vagina does not absorb it as well in the presence of blood. If taking misoprostol vaginally, you can start Step 2 anywhere from 6 to 48 hours after Step 1.
How to take misoprostol buccally (between your cheeks and gums)
This method causes more nausea than the vaginal method, but less than the sublingual method. If taking misoprostol buccally, you can start Step 2 anywhere from 24 to 48 hours after Step 1.
How to take misoprostol sublingually (under the tongue)
This method causes more nausea because misoprostol is absorbed SO well under the tongue that it can start working faster and as a consequence, be much more intense. This route can therefore cause more side effects. If taking misoprostol sublingually, you can start Step 2 anywhere from 24 to 48 hours after Step 1.
Choose a time to start Step 2 when you’ve had a good meal and plenty of rest, as bleeding and cramping usually start a few hours after Step 2. 30 minutes before taking your misoprostol pills, take 800 mg of ibuprofen (pain medicine) by swallowing with water and one ondansetron pill (anti-nausea medicine) under your tongue. The ondansetron dissolves in your mouth and does not need to be swallowed. These medicines will help decrease some of the GI side effects, like nausea, that are common with misoprostol, as well as help decrease cramping.
You must complete Step 2 even if you have started bleeding.
Step 2: Take 4 Misoprostol Pills
Place 4 (four) misoprostol pills (800 mg) inside your vagina OR between your cheeks and gums for 30 minutes. Below we go over the different ways to take them—choose the one you prefer. The medicine works equally well across each option, but can cause more nausea when taken sublingually (under the tongue) and the least nausea when taken vaginally.
First, go to the bathroom to empty your bladder and wash your hands.
Either in a squatting position or lying on your back or side, use your finger to push 4 misoprostol pills, one by one, deep into your vagina at least one finger’s distance inside. After the pills are inserted, lie down and wait for 30 minutes.
Do not use lube if inserting the pills vaginally. Instead, you can moisten the pills with a little water prior to inserting to make vaginal administration easier.
After 30 minutes, the medicine is absorbed. If the pills fall out after 30 minutes, it is ok and the pills can be thrown away.
Put 2 misoprostol pills on one side of your mouth between your cheek and gums (think the place where you used to hide chewing gum), and the other 2 misoprostol pills on the other side of your mouth. Wait 30 minutes for the pills to dissolve, then swallow what is left of the pills. It is okay to swallow your saliva as the pills dissolve.
Put 4 misoprostol pills under your tongue and hold them there with your mouth closed so the pills stay in place. Wait 30 minutes for the pills to dissolve, then swallow what is left of the pills. It is ok to swallow your saliva as the pills dissolve.
Depending on how many weeks along the pregnancy is and on how much you bleed after Step 2, you may or may not need to take additional pills as described in Step 3.
You only need to complete Step 3 if:
- The pregnancy is 9 weeks or more
- The pregnancy is less than 9 weeks and you have not experienced bleeding, passed clots, or passed tissue 24 hours after Step 2.
(Note: It is common for bleeding to be lighter than a period for people that are earlier in their pregnancy, typically 6 weeks or less).
Repeat Step 2 by taking the extra 4 misoprostol pills either buccally (between your cheeks and gums) or sublingually (under your tongue). Wait 30 minutes for the pills to dissolve, then swallow what is left of the pills.
You can also take the 4 misoprostol pills vaginally, but only if you have not started bleeding yet. After 30 minutes, the medicine is absorbed. If the pills fall out after 30 minutes, it is ok and the pills can be discarded.
Do something that makes you feel good! Whether this process was a big deal for you or just another day, take some time to listen to your body, and do something nice for yourself. It’s safe to go back to your regular activities – school, work, driving, exercise – as soon as you feel up to it. You can have sex whenever you are ready (more about sex after an abortion here), and can use tampons or menstrual cups once your bleeding has lightened up.
