FAQ about Medication Abortion

Yes, you can sleep after taking misoprostol. Many people take the second dose of the abortion pill, misoprostol, at night for privacy or convenience, and with the right pain medicine, some sleep through the cramping, though pain is different for everyone. You get to choose when and where your abortion happens. Misoprostol usually starts working within a few hours, bringing cramping and bleeding which can feel like a heavy period for some or more intense for others. It’s important to know that cramping and bleeding can start and stop throughout the process. This guide answers the most common questions about the abortion pill, including how it works, what to expect, safety, and cost.

What is medication abortion, and how does it work?

Medication abortion is a safe, FDA-approved way to end an early pregnancy using two medicines: mifepristone and misoprostol. It’s more accurate to call it abortion pills than just “the abortion pill,” because it’s actually multiple pills and works in two steps.

The first medication, mifepristone, blocks a hormone called progesterone that a pregnancy needs to keep growing. The next medication, misoprostol, usually taken 24 to 48 hours later, causes cramping and bleeding that empties the uterus, much like a miscarriage.

Most people complete the process safely at home after ordering abortion pills online. It’s private, highly effective, and has been used by millions of people safely for more than twenty years.

When do I take the second abortion pill? Can I sleep after taking misoprostol?

Yes, you can sleep after taking misoprostol. You can take the second pill anytime within 72 hours of the first, and many people choose to take it at night for privacy or convenience. With the right pain medicine, some people sleep through the strongest cramping, though pain levels are different for everyone. One of the benefits of the abortion pill is that you decide when and where your abortion happens.

How long does misoprostol take to work?

Misoprostol usually starts working within a few hours. Most people begin to feel cramping and see bleeding 1 to 4 hours after taking it, which is the sign the medicine is doing its job. Bleeding and cramping can come in waves or start and stop throughout the process.

The most intense cramping usually happens about 4 to 6 hours after taking the misoprostol. After you pass the pregnancy, pain and bleeding should start to get better. For some, it’s normal to have some cramping and bleeding off and on for the next few days.

If you haven’t started bleeding within 24 hours, text Cara or call your provider. Sometimes an additional dose of misoprostol helps, and your care team can walk you through the next step.

How long after taking misoprostol does bleeding start?

Bleeding usually starts within 1 to 4 hours of taking misoprostol. It typically begins with cramping, followed by heavier bleeding and blood clots as the pregnancy passes. This is normal and expected. The size of the blood clots, the amount of bleeding, and the color of the blood can vary depending how far along you are in pregnancy.

Everyone’s body is a little different, so some people bleed sooner, and others take longer. For a full picture of what’s normal in the days that follow, see our guide on abortion recovery. If you soak through two large pads an hour for two hours in a row, or pass blood clots that are larger than a lemon, contact your licensed provider or health center.

Can you eat after taking misoprostol?

Yes, you can eat after taking misoprostol. Some choose to insert misoprostol vaginally, and others choose a buccal route, meaning you tuck it between your cheek and gumline and leave it there to dissolve. If you are taking it buccally, wait for the tablets to dissolve (typically 30 minutes), swallow what’s left of the pills with water, then you can eat and drink normally. Since misoprostol can make some people nauseous, it's a good idea to eat lightly. Things like broth based soups, crackers, toast, or cereal.

If you ordered abortion pills online from carafem, you also received a comfort kit with an anti-nausea medication. The medicine, ondansetron, can help manage nausea if you are feeling anxious or sick to your stomach.

When is it too late to take the abortion pill?

The abortion pill works up to 12 weeks of pregnancy, which is measured from the first day of your last period. If you are having trouble figuring how far along you are, using a pregnancy calculator can help. You can also talk to your provider or care team and they can help you confirm your timing. If you’re further along than 12 weeks, you still have options, and carafem can help you find the right care.

Is the abortion pill safe?

Yes. The abortion pill has been used safely by hundreds of thousands of people in the United States since 2000, and it’s one of the most studied medicines available. Serious complications are rare. Using the abortion pill has no proven effect on your ability to get pregnant or have healthy pregnancies in the future.

What does the abortion pill feel like?

For some people, taking the abortion pill feels like a heavy period, which can be uncomfortable, for others, it can be painful. It’s different for everyone and varies depending on how far along you are at the time. It’s normal for pain, cramps, and bleeding to come in waves or start and stop throughout the process. Common symptoms in the hours after taking misoprostol include:

• Cramping and aches in your stomach

• Heavier bleeding, sometimes with large clots

• Nausea or vomiting, or diarrhea

• Feeling dizzy or tired

• A low fever (99 to 100°F) or chills on the day you take misoprostol

Your carafem comfort kit includes pain and anti-nausea medicine to help you manage these symptoms. If you are using abortion pills for a current pregnancy, you will also have 24/7 text based support from Cara. For more details, see abortion pill side effects and do abortions hurt? If you pass blood clots larger than a lemon or are bleeding through two pads an hour for two hours in a row, call your licensed provider or health center right away.

How effective is the abortion pill?

The abortion pill is very effective; about 98% of people have a successful abortion with medication. A small number of people may need additional medicine or follow-up care if the pregnancy doesn’t fully pass, but if your pregnancy symptoms are starting to go away and you had a negative pregnancy test 2-3 weeks after your abortion, it’s likely the abortion pills worked.

How do I know if the abortion pill worked?

If your pregnancy symptoms are starting to go away, like less pain, less bleeding, less feeling sick, this is a sign that the abortion pill worked. It’s a good idea to take a pregnancy test 2 to 3 weeks after you take the abortion pill to confirm you are no longer pregnant. If you took a test within the first few weeks and have a positive test result, you may want to take another test a few weeks later because some people may need more time for the pregnancy hormone to leave their body. This is normal. This is why bleeding and breast tenderness can take longer to go away.

Learn more about post abortion follow up care here.

How much does the abortion pill cost?

At carafem, the abortion pill costs $0 to $399 for online care. An in-person visit for the abortion pill costs $0 to $475 ($0 to $450 in Washington, DC), depending on which location you choose. Pricing is on a sliding scale, so many people pay less, and some pay nothing.

Immediate Evaluation can’t be billed to insurance or Medicaid; however carafem partners with abortion funds to help reduce the cost of abortion care for those who qualify. If you have Illinois or Maryland Medicaid, you can schedule a video visit and to discuss using insurance to get abortion pills by mail. If cost is a barrier, carafem can discuss financial assistance options to help lower the cost of care.

How do I get the abortion pill?

The best way is to get the abortion pill from licensed providers experienced in abortion care. carafem offers Immediate Evaluation for the abortion pill online, with medications mailed to your home or wherever works best for you. If you live near Washington, DC, Chicago, or Atlanta, you can book an in-person visit at one of carafem’s health centers. Abortion pill appointments take less than an hour and can often be scheduled within a few days, sometimes the same or next day.

If you live elsewhere, you may still be able to find care near you. The decision to have an abortion and how you choose to do it is completely up to you. When you’re ready, you can get started online or call (855) 729-2272.