Medication Abortion (Abortion Pill)
The medication abortion procedure is more commonly known as the “abortion pill.” It uses a drug combination of Mifepristone and Misoprostol, which is called Mifegymiso. This procedure is completed over two days and is generally only performed until 70 days (10 weeks) of pregnancy.[1] View the Mifegymiso product monograph for more information.
Day 1 - Mifepristone
On day one, the first pill, mifepristone, is taken orally to block the hormone progesterone. Progesterone is essential for maintaining the uterine lining in early pregnancy, allowing the embryo to receive nutrients and continue developing.[2] By blocking progesterone, mifepristone causes the uterine lining to break down, shutting off the supply of blood and nutrients.[3]
The second abortion pill, Misoprostol, will be sent home with the patient, who will have to follow all the instructions given for taking the remaining set of drugs. The patient is responsible for judging whether their body’s reaction to the abortion pill is normal or abnormal.[4]
Reversal
If you or someone you know took the abortion pill and regrets it, there may still be time. The Abortion Pill Reversal provides free and confidential care 24/7
Call 877-558-0333.
This treatment reverses the effects of the first abortion pill and allows you to continue your pregnancy if you contact them as soon as possible before taking Misoprostol. After taking the first pill, some women regret their choice and want to reverse it. By re-administering the pregnancy hormone progesterone, medical professionals have reported saving 64–68% of pregnancies through abortion pill reversal.[5]
Day 2 - Misoprostol
24 to 48 hours after taking Mifepristone, the Misoprostol pills are inserted buccally or vaginally. Misoprostol causes uterine contractions and cramping, which expel the embryo or fetus. This process also expels the placenta, amniotic fluid, and uterine lining.[6]
These effects generally start 1 to 4 hours after taking Misoprostol, with contractions and bleeding typically lasting 2 to 6 hours.[7] Contractions and bleeding can be intense and painful. Many women also experience nausea, vomiting, diarrhea, abdominal pain, and headaches.[8]
Unlike a surgical abortion, the patient is responsible for managing the process of passing all pregnancy tissue at home. Patients often sit on a toilet as they prepare to expel the pregnancy tissue, which may then be flushed.[9]
Note that it is not uncommon for women to see the embryo or fetus within the pregnancy sac after it has passed.
Typically, the patient will return to the clinic about two weeks later for a follow-up appointment to determine if the abortion is complete and no pregnancy tissue remains in the uterus. A surgical abortion may still be required in some cases.[10]
Abortion Pill Complications:
The abortion pill has a 2.0 to 4.8% failure rate before 49 days of gestation, according to the official product monograph.[11] The abortion pill is most successful during the earliest weeks of pregnancy.¹ As gestational age increases, so do failure rates. By ten weeks, effectiveness may decrease to about 87%.[12] Abortion pill failure is either complete or partial.
Partial Failure / Incomplete Abortion:
In some cases, the abortion pill may result in an incomplete abortion where pregnancy tissue fails to be expelled. In this situation, pregnancy tissue remains in the uterus, which may lead to prolonged bleeding, infection, or other complications. Seek medical attention. A surgical abortion may be required.[13]
Complete Failure / Ongoing Pregnancy:
There are rare situations where the pregnancy continues despite taking the abortion pill. If little to no bleeding occurs after taking the second pill, that can be an indicator that the abortion failed entirely. An ultrasound would be needed to determine whether the pregnancy is still viable with certainty.[14]
Other Complications:
If a patient is experiencing excessive bleeding (2 to 3 maxi pads per hour) or a prolonged fever of 38.5°C or higher after their abortion, they must seek emergency care. [15]
See our Abortion Risks page for further information on the side effects of the abortion pill.
(It is strongly recommended that patients understand all available options before making an irreversible medical decision. Please contact us if you would like more information on pregnancy options and available support.)
[1]Celopharma Inc. (2019). Mifegymiso product monograph. Health Canada.https://pdf.hres.ca/dpd_pm/00050659.PDF
[2]Cleveland Clinic. (2022). Progesterone.https://my.clevelandclinic.org/health/body/24562-progesterone
[3]Healthgrades. (n.d.). Abortion pill: What to know.https://resources.healthgrades.com/right-care/pregnancy/abortion-pill
[4]Live Action. (n.d.). What is abortion?https://www.liveaction.org/what-is-abortion
[5]Abortion Pill Reversal. (n.d.). Abortion Pill Rescue Network.https://abortionpillreversal.com
[6]Mayo Clinic. (2024). Medical abortion.https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
[7]Cleveland Clinic. (2024). Medical abortion.https://my.clevelandclinic.org/health/treatments/21899-medical-abortion
[8]Drugs.com. (n.d.). Misoprostol side effects.https://www.drugs.com/sfx/misoprostol-side-effects.html
[9]Live Action. What is abortion?https://www.liveaction.org/what-is-abortion
[10]Mayo Clinic. Medical abortion.https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
[11]Celopharma Inc. Mifegymiso product monograph. Health Canada.https://pdf.hres.ca/dpd_pm/00050659.PDF
[12]Medical News Today. (2024). What does the abortion pill do? https://www.medicalnewstoday.com/articles/what-does-the-abortion-pill-do
[13]Women’s Reproductive Clinic. (n.d.). Abortion pill failure.https://mfpiclinic.com/abortion-pill-failure
[14]American College of Obstetricians and Gynecologists. (2020, October). Medication abortion up to 70 days of gestation (Practice Bulletin No. 225).https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-days-of-gestation
[15]Sajadi-Ernazarova, K. R., & Martinez, C. L. (2021). Abortion complications. StatPearls Publishing.