How do I take the abortion pills? Pills Usage
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.
Key takeaway
Medication abortion with Trust Abortion Pill is a safe and private way to end an early pregnancy at home using FDA-approved mifepristone and misoprostol, if prescribed.
- 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).
- Warning signs: Seek immediate medical care for soaking 2+ maxi pads per hour for 2+ hours, a fever over 101°F, or severe pain.
- Trust Abortion Pills support: Treatment includes the medications, a detailed guide, 24/7 nursing line access, and on-demand clinical messaging.
Step 1: Swallow 1 Mifepristone pill with water
Definition: Mifepristone
The 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
Step 2: Take your comfort medicines and misoprostol pills
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 Hey Jane 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.
Step 3: Take the additional misoprostol pills (if needed)
You only need to complete Step 3 if:
- The pregnancy is 9 weeks or more—wait 4 hours and then complete Step 3 OR
- The pregnancy is 8 weeks and 6 days or less and you have not experienced bleeding or passed blood clots/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).
Complete Step 3 by taking 4 misoprostol pills—either under your tongue or between your cheeks and gums. Wait 30 minutes for the pills to dissolve, then swallow what is left of the pills.
You can also take 4 misoprostol pills vaginally, but only if you have not started bleeding yet. Wait 30 minutes for the pills to be absorbed. If the pills fall out after 30 minutes, it is okay and you can throw them away.
Note: If the pregnancy is less than 9 weeks and you have experienced bleeding or passed blood clots/tissue within 24 hours after Step 2, you can skip Step 3.
What should I expect after taking abortion pills?
Remember that each person’s experience is different and symptoms can vary from person to person.
| Common abortion pill symptoms | Description |
|---|---|
| Bleeding | Heavy bleeding usually starts 4-6 hours after taking the second medicine, misoprostol. |
| Pain and cramping | Intense cramping usually starts a few hours after taking misoprostol and gets better after a few hours. |
| Fever and chills | These symptoms are common during the first 24 hours after taking the second medicine, misoprostol before going away. |
| Headache | Ibuprofen or acetaminophen can help. |
| Nausea, vomiting, or diarrhea | This should go away 1-2 days after you take the pills. |
| Feeling tired | You may feel tired for a couple of days. You should be back to normal soon. |
| Breast changes | Breast tenderness tends to hang around the longest and can take up to 2-3 weeks to resolve, but you should start to notice an improvement within 1-2 days after treatment. You may leak a milky discharge—wear a snug-fitting bra if you do. This should stop in a couple of days. |
| Sadness or mood changes | You may feel relieved when the abortion is over. You may also feel sad or moody, which is normal and can come from hormonal changes when you’re no longer pregnant. If you think your emotions are not what they should be, please reach out to your Hey Jane provider. There are also great support text and talk lines on our Resources page. |
How do I take care of myself after a medication abortion?
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.
