There are 2 steps in the medical abortion process
The First Step
1 tablet of Mifepristone (green pack) will be taken orally at the Clinic
as directed by your doctor.
The Second Step
24 to 48 hours after taking mifepristone at the Clinic you will need to take the misoprostol tablets (orange pack). It is up to you when you take the misoprostol tablets within this time period. You can be at home or wherever is comfortable for you and where you will be able to rest. You may also want to have someone you trust with you or nearby for support.
You will take the 4 misoprostol tablets from the orange pack at the same time. You will take the misoprostol tablets by holding the tablets in your mouth, between the cheek and gum, for 30 minutes. Any fragments left after 30 minutes can be swallowed with a glass of water.
Please note that it is recommended you do not travel away from home during your medical abortion treatment (14 days) so that you can visit the clinic if necessary.
What To Expect
Symptoms of Medical Termination of Pregnancy
Once you have taken the 4 misoprostol tablets (second step) you can expect some vaginal bleeding, cramps, and to pass blood clots and some pregnancy tissue. This commonly occurs within 4 hours; however, in some cases it may occur anywhere between 30 minutes and 48 hours after taking the misoprostol tablets. It is recommended to rest for 3 hours after taking the misoprostol tablets.
Please note that sometimes bleeding can occur after taking mifepristone (first step) and before taking misoprostol (second step).
To the right, you can review the most common symptoms you may experience as part of the medical abortion process.
- The onset of bleeding is usually within 4 hours and most women will experience the onset within 48 hours
- Bleeding can range from light to heavy and it is normal to see blood clots and tissues
- The bleeding lasts on average for 11 days and may be heavy for 2 to 3 days
- Light bleeding can continue for 30 days or more
- Cramping can start within 4 hours of taking the misoprostol tablets
- Cramping can range from mild to severe and is usually more than a typical menstrual period
- Significant cramping should diminish once the pregnancy is expelled. This does not usually last longer than 24 hours
The following side effects are usually short term and do not last more than 24 hours:
- Breast tenderness
- Hot flushes and chills
- Nausea, vomiting, diarrhea, dizziness
For pain management we recommend:
- Use of hot packs on your abdomen or back
- Massaging of the lower abdomen frequently
- Pain relief medications as directed by your doctor
When to Call Us
Call us right away if you:
- have no bleeding within 24 hours after taking misoprostol (second step)
- have heavy bleeding that soaks through two or more sanitary pads per hour for 2 consecutive hours
- pass large clots for more than 2 hours
- have cramps that do not get better with pain medication
- have a fever of 100.4 or higher more than 24 hours after taking misoprostol (second step)
- have weakness, nausea, stomach pain, vomiting, and/or diarrhea that lasts more than 24 hours after taking misoprostol (second step)