How to Take Abortion Pills

Preparing for abortion pills can help make the process more comfortable. There are a few ways you can prepare, including gathering some simple supplies to have at home, choosing where and when you want to have the abortion, and thinking about what kind of support you might want to have during the process. We're here to help so you know how to prepare for abortion pills.

Here's a list of supplies to have with you before you start your abortion. You can find them at your local pharmacy, grocery store, or convenience store:

• Maxi pads (heavy flow is best)

• Over-the-counter pain medicine. You can choose Ibuprofen (800mg), Naproxen (440mg), or Acetaminophen (1000mg). Whichever you normally like to use for pain or cramping is fine.

• A heating pad or hot water bottle (to help with cramps)

• A thermometer (to check if you have a fever)

• Water or other drinks you like to stay hydrated

• Light snacks that are easy to eat if you feel nauseous

Your abortion will happen over the course of several hours. So it's helpful to think about when and where is best for you to be cramping and bleeding. Here are some things to think about:

• Where do you want to have the abortion? It might be at home, or at a friend's house, or somewhere else. You'll need to be near a bathroom for up to 12-24 hours. You might want to think about where is most private, as well as where is most comfortable.

• When do you want to have the abortion? Most likely the abortion process will start within a few hours of taking the misoprostol. Think about your work or school schedule, sleep schedule, and privacy. Some people choose to take the misoprostol in the evening so the heaviest bleeding is overnight. Others may choose morning so they have the abortion during the day.

• Can you plan for time to rest? Many people need a day or two to rest after the abortion, so you may want to plan for that if you can. Some people feel well enough to go back to normal activities the next day. We know it's not always possible to get a lot of rest time. So think about what's possible for you.

It can be helpful to think through emotional or physical support options before you have the abortion. That way if you want or need help, you already have a plan. Lots of people go through a medication abortion alone just fine, and we're here for you with any questions or concerns you have along the way. Here are some things to consider:

• Emotional support: Some people find it helpful to have a trusted friend, partner, or family member with them during their abortion for emotional support. Others may prefer to be alone, but tell someone they trust who they can call if they want support. You can decide what feels good and safe for you.

• Physical support: You may want to have someone who knows about your abortion to be ready in case you need physical help, like getting something from the store for you, making a phone call for you, or taking you to a doctor in the very unlikely case where you need that. You can decide what feels right for you.

• If you live in a state where abortion is banned, think about how safe you feel telling someone and asking if they can be a support person for you. It's safest to only tell someone if you're sure they'll support you and keep the abortion private.

• Phone numbers to have on hand: At Home Abortion will email you a phone number when your pills ship. You can call us anytime with questions or concerns. We're happy to support you in your abortion process. There are also other helpful resources you can call or text, like the M+A Hotline (833-246-2632) and Reprocare Hotline (833-226-7821).

At Home Abortion will provide detailed instructions for abortion pills by email. This page also gives abortion pill instructions, including how to take abortion pills and what to expect during your medical abortion pills process. We're here with you every step of the way. You can always contact us with any questions or concerns using the number we gave you.

The first abortion pill you'll take is mifepristone. Here's how to take mifepristone:

1. If you get your pills from At Home Abortion, we include anti-nausea medicine (ondansetron) for you to take first. So your first step will be to swallow this medicine with water.

2. Then you'll take mifepristone. You'll also swallow this pill with water.

Most people don't have any symptoms after taking mifepristone. Some people have nausea or some bleeding. The anti-nausea medicine will help prevent feeling sick from mifepristone. Whether or not you have any symptoms or side effects, take the misoprostol when it's time.

You'll take the misoprostol 1-2 days (24-48 hours) after taking your mifepristone. You can choose when to take misoprostol after mifepristone based on when it works for you to start the cramping and bleeding.

The process of taking misoprostol is a bit more complicated. First, you have three different options of how to take misoprostol:

• Buccal (in your cheeks): Put pills on each side of your mouth, between your gums and the inside of your cheeks. Let them dissolve for 30 minutes. Then swallow what's left with water.

• Sublingual (under your tongue): Put pills under your tongue. Let them dissolve for 30 minutes. Then swallow what's left with water.

• Vaginal (in your vagina): Put pills deep into your vagina using clean fingers. Lay down for 30 minutes so they can dissolve. If any pills fall out after you get up, you can throw them away.

Whichever feels most comfortable for you is best. There's no medical reason why one option is better than another. But here are a few things to keep in mind:

• If you're very worried about nausea or throwing up while the pills are in your mouth, you may want to choose vaginal.

• If you need to take more doses of misoprostol and you're already bleeding, use the buccal or sublingual method. If you use vaginal while you're bleeding, the pills won't stay in your vagina very well.

Once you've decided which method is best for you, you can start the process. Here are your step-by-step instructions for taking misoprostol:

1. Take your anti-nausea medicine (ondansetron).

2. Take pain medicine if you want. You can take 800mg of ibuprofen (4 of the 200mg over the counter pills) or 440mg of naproxen (2 of the 220mg over the counter pills) or 1000mg acetaminophen (2 of the 500mg over the counter pills). You can repeat ibuprofen or acetaminophen every 6 hours or naproxen every 12 hours as needed. If you're in a lot of pain, you can take ibuprofen or naproxen, and acetaminophen at the same time.

3. Use 4 misoprostol pills either in your cheeks, under your tongue, or in your vagina. Some people get sick and throw up. That means the medicine is working.

4. Keep any leftover misoprostol pills, just in case.

If you're between 9 weeks and 11 weeks + 6 days pregnant:

• Three hours later, use 4 more misoprostol tablets the same way you did the first time.

If you're 12-14 weeks pregnant:

1. Three hours later, use 2 more misoprostol pills the same way you did the first time.

2. Three hours after that, take 2 more pills in the same way.

3. Continue with 2 tablets every 3 hours until the pregnancy passes.

It can be helpful to know what to expect after taking abortion pills so you're not surprised and know what to do. This section walks you through what's normal and what's not each step of the way.

Here's what to expect after taking misoprostol in the first few hours:

• It usually takes about 2-4 hours for cramping and bleeding to start, but everyone is different. For some it starts sooner and others it starts later, up to 6 hours.

• Cramping and bleeding means that the medicine is working.

• Once you take the misoprostol, you should be ready in your comfortable space near the bathroom.

Once the cramping and bleeding start, it will continue and start to fade until the abortion is complete. Here's what to expect during your abortion:

• Cramping and bleeding will start about 2-4 hours after taking misoprostol. The heaviest bleeding usually lasts for about 12-24 hours. Most people find the abortion is done within 24 hours.

• Bleeding can be heavy. It's usually heavier than a regular period.

• You may also pass blood clots. These clots can range in size from small to large. Up to the size of a lemon is normal. The more weeks pregnant you are, the more likely you are to pass larger clots.

• If you're more than 9 weeks pregnant, you might see a small fetus and even a placenta.

• You may have side effects like nausea, vomiting, and fever. This is normal.

Here's what to expect after an abortion:

• After the abortion is complete, you may still have some bleeding for a while. It will get lighter, but spotting is normal for up to 4-8 weeks after an abortion.

• Cramping should get much better and go away after a day or two.

• Most people are able to return to normal physical activities within a day or two.

• You can have sex after your abortion as soon as you feel ready.

• If you had any pregnancy symptoms like nausea or sore breasts, they should go away quickly after the abortion is complete. If you're worried you're still pregnant, contact us.

• Pregnancy tests can still show up positive for up to 5 weeks after your abortion, even if the abortion worked.