The Abortion Pill

Updated February 18, 2026

The abortion pill is a two-step medication process that ends a pregnancy. You take pills at home. It feels like a heavy, crampy period or early miscarriage.

What The Pills Are Called

  • Mifepristone (also called Mifeprex or RU-486): The first pill. Blocks progesterone, a hormone needed for pregnancy to continue.
  • Misoprostol (also called Cytotec): The second pill. Causes cramping and bleeding to empty the uterus.

Together, this is called medication abortion or medical abortion. Most people just call it the abortion pill.

How It Works

Note: You should only use the pill if you are under 12 weeks pregnant.

  1. Take mifepristone
    • You swallow one pill with water. Most people feel nothing after this pill. Some have light spotting. This stops the pregnancy from growing.
  2. Take misoprostol 24-48 hours later
    • You take 4 pills. There are a couple ways to take them:
      • Buccal: Put 2 pills between your cheek and gum on each side. Let them dissolve for 30 minutes. Swallow what is left.
      • Sublingual: Put all 4 pills under your tongue. Let them dissolve for 30 minutes. Swallow what is left.

Sublingual causes the most nausea. Buccal is in between. All work equally well.

This causes cramping and bleeding that empties your uterus.

What It Feels Like

  • After mifepristone: Most people feel fine. No symptoms. You can do normal activities.
  • After misoprostol: This is when symptoms start. Usually 1-4 hours after taking the pills.
  • Cramping: Strong cramps like a bad period. Worse than regular period cramps for most people. Take ibuprofen 30 minutes before the misoprostol. It helps.
  • Bleeding: Heavy bleeding with clots. Clots can be large, up to the size of a lemon. This is normal. You will see blood clots and tissue. The pregnancy tissue itself is very small at this stage. At 8 weeks, an embryo is about 1/4 to 1/2 inch long. You may not see it when it passes.
  • Other symptoms: Nausea, vomiting, diarrhea, chills, low-grade fever (99-100°F), fatigue, dizziness. These are side effects of the misoprostol. They usually go away within 24 hours.

How Long It Takes

Most people pass the pregnancy tissue in 4-5 hours after taking misoprostol. Some take longer. This is normal.

The worst cramping and bleeding usually last a few hours. Then it slows down.

You may have cramping on and off for 1-2 more days. Bleeding and spotting can continue for several weeks. This is normal.

What To Have Ready

  • Pain medication (ibuprofen, not aspirin)
  • Anti-nausea medication if your provider gives it to you
  • Menstrual pads (not tampons during the active bleeding)
  • Heating pad or hot water bottle
  • Water and snacks
  • A comfortable place to rest
  • Access to a bathroom
  • Someone you trust nearby if you want company (not required)

Plan to take the day off Most people feel better the next day, but the day you take misoprostol can be intense.

When To Call A Doctor

If you are concerned that you may need to seek medical care during your self-managed at home abortion, call or text the Miscarriage & Abortion Hotline. They are a team of volunteer clinicians with decades of experience in miscarriage and abortion. They can advise you if you should seek medical attention, and on exactly what to say.

The Pill’s Legality

Federal Law: The FDA approves mifepristone and misoprostol. They are prescription medications. Certified healthcare providers can prescribe them. Certified pharmacies can dispense them.

Possessing the pills: In most states, it is not illegal for you to possess abortion pills. The laws target providers, not patients.

Distributing the pills: Giving abortion pills to someone else can be illegal depending on the state. This includes mailing them to someone.

Prescribing the pills: Only certified healthcare providers can legally prescribe mifepristone. In states where abortion is banned, prescribing abortion pills is illegal. For Idaho specifically: See our Laws In Idaho page. Medication abortion is illegal in Idaho. You cannot legally get a prescription for abortion pills in Idaho. Traveling to another state, getting the pills there, and taking them in that state is legal.

It is not illegal for you to possess the pills in most states. But using them for abortion may be illegal depending on where you are.

Frequently Asked Questions

How do I know if it worked?

Heavy bleeding and passing clots are signs it is working. Most people know it worked because the bleeding happens. Your provider may have you take a pregnancy test 2-3 weeks later or get an ultrasound to confirm. If you do not bleed within 24 hours of taking misoprostol, call your provider.

Can I be alone when I take the pills?

You do not have to be alone, but you can be if you want. Many people prefer to be home alone or with one trusted person. Make sure you are within 30 minutes of emergency care in the rare case you need it. Have a phone to call for help if needed.

Can I get the abortion pill in Idaho?

Yes. Telehealth is not banned, so a prescription and shipment can be handled through an out-of-state provider. It is also not illegal for providers to ship to Idaho. PlanCPills.org is a good resource to find telehealth services.

Can I use just misoprostol without mifepristone?

Yes. Misoprostol-only abortion is effective and safe. It is about 85-95% effective compared to 98% for the two-pill combination. Some providers offer misoprostol-only abortion. It requires more pills and may have more side effects like nausea and diarrhea.

Does the abortion pill hurt?

Yes, it can cause intense cramping like a really bad period. This varies for everyone. Some people have mild cramps. Some have severe cramps. Take ibuprofen. Use a heating pad. The cramping gets better once the pregnancy passes.