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Safe Abortion Services — Pills, Costs & What to Expect
Key takeaway
Medication abortion with Trust Provider is a safe and private way to end an early pregnancy at home using FDA-approved mifepristone and misoprostol.
Medications: The process requires mifepristone followed by misoprostol, typically supported by ibuprofen and anti-nausea medication to manage side effects.
Supplies: Prepare with heavy-flow menstrual pads, a heating pad, hydration, and light snacks for comfort.
Schedule: Mifepristone is taken first, and misoprostol is taken 6-48 hours later depending on the method used (oral or vaginal).
How do I take the abortion pills?
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.
Abortion pills, known as medication abortion, are a safe and effective way to end a pregnancy. The FDA-approved two-pill regimen is up to 98% effective when taken within 10 weeks, according to the FDA.
Step 1: Swallow 1 Mifepristone pill with water
Definition:
MifepristoneThe first FDA-approved medication in a medical abortion. It blocks the hormone progesterone to stop the pregnancy from growing.
Most people carry on their day normally after taking this medicine, while others may experience bleeding or cramping. Either is okay. Complications are rare, occurring in less than 0.5% of patients.
Swallow one mifepristone pill with water.It’s unlikely, but if you throw up in the first 30 minutes after taking mifepristone, please message your care team as soon as possible. If you throw up after 30 minutes, you do not need to contact your care team as the medicine has been absorbed.
Optional: If you tend to get nauseous, you’ve been feeling nauseous with the pregnancy, or you feel nauseous after taking the mifepristone you can take one ondansetron (anti-nausea) pill under your tongue and let it dissolve at least 30 minutes before starting Step 1. This medication is included in your Trust Abortion Pills treatment.
Step 2: Take your comfort medicines and misoprostol pills
You can take the second type of pill, misoprostol, several different ways: vaginally, between your cheeks and gums (buccally), and under your tongue (sublingually). All three methods of taking misoprostol are equally effective, according to a 2019 Cochrane review.
The difference is in side effects as sublingual causes the most nausea, while vaginal causes the least.Choose a time to start Step 2 when you’ve had a good meal and plenty of rest, as bleeding and cramping usually start within a few hours after Step 2.
We strongly recommend taking both ondansetron (antinausea) and ibuprofen or acetaminophen (pain relief) medicine at least 30 minutes before taking the misoprostol. Please follow the instructions on your pill bottles.
Definition:
MisoprostolThe second FDA-approved medication in a medical abortion treatment. It causes the uterus to cramp and empty, with light to heavy vaginal bleeding.
It is taken 6-48 hours after mifepristone, depending on whether you take the misoprostol by mouth or by inserting it into your vagina.
How to take misoprostol vaginally
This method causes the least nausea, and you can start it anywhere from 6 to 48 hours after Step 1. 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 fingers to push 4 misoprostol pills (one by one) deep into your vagina. They should be at least one finger’s distance inside. After the pills are inserted, lie down and wait for 30 minutes.
After 30 minutes, the medicine is absorbed. It is okay if the pills fall out after 30 minutes, and they can be thrown away. If they fall out before 30 minutes, please message your care team.
Tip: Do not use lube to insert the pills vaginally. Instead, you can moisten the pills with a little water before insertion to make this method easier.
How to take misoprostol between your cheeks and gums (buccally)
This method causes some nausea—more than inserting misoprostol into your vagina, but less than letting it dissolve under your tongue. It can be started 24-48 hours after Step 1.
Put 2 misoprostol pills on one side of your mouth (between your cheeks and gums) 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.
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.
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.If you throw up after 30 minutes, you don’t need to contact your care team because the medicine is already absorbed.
We recommend you use the anti-nausea medication and focus on staying hydrated with fluids that contain electrolytes.
Step 3: When to take a second round of misoprostol
Depending on how many weeks the pregnancy is and when you start bleeding after Step 2, you may or may not need to take additional pills as described in Step 3.
Check the instructions your Trust provider included in your prescription message and on your pill bottle. If you are uncertain about whether or when to take more misoprostol, send a message in the patient portal during business hours or call the urgent line outside business hours.
