Claire Wolters is a Philly-based reporter covering health news for Verywell.

Heather Mercer is native to Northwest Ohio (go Walleye!) and graduated from Loma Linda University with two doctorate degrees (psychology and public health). She is currently a professor at Owens Community College, as well as a fact-checker for Verywell Health. She has gained experience in a variety of settings, ranging from corporate wellness and preventive medicine, to mental health, chronic disease, and end-of-life care. 

Medication abortion now accounts for more than half of the abortions in the United States. But many are unaware of how it works.

Also known as the abortion pill, medication abortion is safe and effective for up to at least 10 to 12 weeks into a pregnancy. According to a 2022 poll, only 13% of respondents said they had heard, read, or seen “a lot” about the abortion pill, while 24% of respondents had never heard of the abortion pill.

The abortion pill consists of two medicines—mifepristone and misoprostol—made up by five pills. We'll walk you through how these pills work and what you can expect after taking them.

Mifepristone is the first pill. You take it by mouth to terminate an early pregnancy. This is a single tablet with 200 mg of mifepristone, which blocks a hormone called progesterone and stops the pregnancy.

You may experience cramping or nausea after taking mifepristone, but according to Planned Parenthood, this is more common after the second medicine, misoprostol.

In anticipation of cramping that may occur after the second medication, Planned Parenthood recommends taking ibuprofen about 30 minutes before the second treatment.

Note: Mifepristone alone can be a safe and effective way of terminating a first-trimester pregnancy.

Between 24 to 48 hours after mifepristone, you will take the second medicine called misoprostol. It works by emptying the uterus and it may cause cramping and bleeding—similar to a miscarriage.

Misoprostol comes in four 200 µg tablets. They are typically in a hexagon shape. You can take the pills in one of the following ways.

If you choose to take misoprostol buccally, you will:

Alternatively, you can place all four tablets under your tongue for 30 minutes.

If you choose to take misoprostol vaginally, you can insert the pills 0 to 48 hours after taking mifepristone. You will:

After taking misoprostol, you may experience period-like cramping within one to four hours. You will likely experience bleeding four to six hours after insertion, but the process can be longer for some people.

If you feel pain during the process, you could take painkillers or use a hot water bottle. If you have irregular, smelly discharge or excessive bleeding, you should contact your healthcare provider.

When the pregnancy is passed, you may notice blood clots or fleshy pieces in your discharge. You may also experience period-like bleeding for about 10 days after the abortion.

If you are performing a medication abortion later in your pregnancy, at nine or more weeks, you may need an additional dose of misoprostol to effectively end your pregnancy. Your provider may advise taking another three or four misoprostol pills about three hours after the initial four tablets, and repeat this consecutively every three hours until expulsion happens.

After a medication abortion, take extra care of yourself. You might experience physical discomfort from the cramps and bleeding, or emotional distress due to hormonal changes. You might also feel stressed or scared depending on the amount of social support you have and the state you live in.

Based on recommendations from Planned Parenthood, you can prepare the following ahead of time to make the abortion process as comfortable as possible:

If you need counseling or support, you can also call the All-Options hotline at 1-888-493-0092 to talk about your feelings and experience at any point in your pregnancy or abortion process.

Taking the abortion pill is a safe and effective way to terminate an early pregnancy. People who want to undergo a medication abortion can follow these steps on their own or with the help of a provider.

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Guttmacher Institute. Medication abortion now accounts for more than half of all US abortions.

Morning Consult. National tracking poll #2205183.

Planned Parenthood. How does the abortion pill work?

Raymond E, Harrison M, Weaver M. Efficacy of misoprostol alone for first-trimester medical abortion. Obstetrics & Gynecology. 2019;133(1):137-147. doi:10.1097/aog.0000000000003017

Chesterfield Royal. Instructions for the self-administration of vaginal Misoprostol at home for the process of medical termination of pregnancy.

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