Medical abortion

How should you use the abortion pills?

To end a pregnancy the medicines should be used in the following way:

  • First you should swallow one tablet of Mifepristone. This medicine blocks the effects of progesterone, the hormone that is necessary to maintain the pregnancy.
  • 24 hours later you should put 4 tablets of Misoprostol under your tongue and keep the tablets there for at least 30 minutes, until the tablets are dissolved. You can swallow your saliva. After 30 minutes you can swallow the remains of the tablets.
  • 4 hours after using the first dose of Misoprostol, you should put 2 more tablets of Misoprostol in under your tongue. Again keep the tablets under your tongue for 30 minutes. Do not swallow the tablets until after 30 minutes.

Are there other ways to use the Misoprostol?

24 hours after swallowing the Mifepristone, the Misoprostol tablets can be used in one of three ways: under the tongue, vaginally or buccally (in the space between gum and cheek). All methods are equally effective in causing an abortion. However ALL the misoprostol must be used in the same way.

We strongly advise you to use Misoprostol under your tongue. This way, no remains of the pills can be found in the event that you need to go to a hospital. There are no blood tests that can show that you have taken Mifepristone or Misoprostol, so there will be no way to prove that you tried to do an abortion.

In countries where women can be prosecuted for having an abortion, it is not necessary to tell the medical staff that you tried to induce an abortion. You can say that you had a spontaneous miscarriage. The doctor CANNOT see the difference. The treatment is also the same. The treatment is curettage, also known as vacuum aspiration, during which a doctor will remove remaining tissue from the womb. Doctors have the obligation to help in all cases.

If you prefer to use the tablets in your vagina, you should use your fingers to put the Misoprostol tablets in as deep as possible, in the back where the womb starts. If you have a complication and you live in a place where hospital staff might denounce you to the police, check your vagina carefully with your fingers to determine whether all of the tablets have dissolved properly. Remove any undissolved pieces of tablets and then go to the hospital immediately. The pills generally take four days to dissolve completely.

What happens if you do not use Misoprostol in time?

The doctor advises you to use the Misoprostol 24 hours after swallowing the Mifepristone tablet. However it can also be used earlier or later, from 12 hours to 72 hours after swallowing Mifepristone.

More scientific information:

Research has shown that for women with pregnancies of 8 weeks or less, Misoprostol works with the same efficacy whether it is taken at 12 hours, 24 hours, 48 hours, or as much as 72 hours after Mifepristone.7 Though we instruct women to take Misoprostol 24 hours after Mifepristone and strongly encourage women to follow all the instructions for proper use, if a woman takes it slightly earlier or later, this does not effect the outcome of the medical abortion.

What if you take the Mifepristone and then decide not to take the Misoprostol?

If, for some reason, you take the Mifepristone and then decide you will not take the Misoprostol part of the medical abortion regimen, there are a few things that could happen.

  • You might experience a complete abortion without ever taking Misoprostol.
  • You might experience a missed abortion, which means that the fetus is no longer viable, but the products of pregnancy (blood, tissue) do not leave your body. This has to be treated with a vacuum aspiration.
  • It is also possible that your pregnancy might continue. If you decide you want to keep the pregnancy at this point, it is unlikely that the Mifepristone will cause later fetal malformations.

More scientific information:

Research suggests that a fetus that has been exposed to Mifepristone alone and is not aborted will continue to develop normally.

Can you use Mifepristone and Misoprostol if you are still breastfeeding?

It is better not to breastfeed during the first 5 hours after taking Mifepristone and after using Misoprostol. It is best to throw away the milk produced in the first 5 hours.

More scientific information:

It is possible that Mifepristone or the Misoprostol metabolite could be excreted in breast milk, so it is a good idea for women who are breastfeeding to discard milk they have produced during the medical abortion procedure.

Is it safe to have a medical abortion if you've already had one in the past?

Women are fertile for about 40 years. Some women need more than one abortion because for example contraception fails or some women cannot choose when to have sexual relations, or because contraception or information about it is inaccessible.

Having a safe abortion, or more than one safe abortion, has lower risk on woman's health or ability to have children in future than having a spontaneaous miscarriage.

Can you eat or drink while you are taking the medicines?

You should not drink any alcohol or use drugs, as it can affect your judgment. You can eat food and drink liquids as you normally would. However, as some women experience nausea from the misoprostol, you may want to eat lightly.

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