Abortion with Pills

All you need to know & Online consultation: The abortion pill is a safe & effective way to end an early pregnancy at home ✅ We are here to help you

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Every year, thousands of women safely obtain the abortion pill through Women on Web’s online abortion service. If you do not have any severe illnesses, are within the first 10 weeks of pregnancy, and are unable to access an abortion safely in your region, we can help you.

Supervised by medical doctors, our trained helpdesk is available 7 days a week and will answer any questions you may have before, during, and after the abortion process. The helpdesk provides judgement-free support and information on how to do an abortion. They will explain how to correctly use the medication, what to expect, and how to recognize if you are having potential complications. 

Prior to accessing the service, you will be asked to complete an online consultation. The consultation is designed to familiarize our medical staff with your situation. An online consultation is just like an in-person appointment with a medical practitioner: it will ask you questions about your pregnancy and medical history to determine if you can safely have a medical abortion. All the information you provide us will be kept confidential. 

A medical abortion (also known as abortion with pills) is a safe and effective option for terminating early pregnancies. Medical abortion is easy to administer and can be safely done in the privacy of your own home. Managing your own abortion within the first 12 weeks of the pregnancy has a low risk of complications. The process and side effects of a medical abortion are the same as having a miscarriage and carry the same health risks. 

Medical Abortion Before 12 Weeks

A medical abortion, also known as “abortion with pills”, “self-managed abortion” or “home abortion”, refers to using medication to terminate a pregnancy. The World Health Organization (WHO) recommends self-managing abortions as a safe, acceptable, and empowering option up to 12 weeks of pregnancy. Medical abortion consists of a combination of two medications, Mifepristone and Misoprostol. If you’re in a country where Mifepristone is not available, you can do a medical abortion using just Misoprostol.

When you do the abortion, choose a private place where you can rest and stay hydrated. It is recommended to have a trusted person with you for safety, company and support.

Medical abortion with Mifepristone and Misoprostol (Cytotec)

A medical abortion using Mifepristone and Misoprostol is the most common and effective method. The Mifepristone is taken first and blocks the hormones needed to sustain the pregnancy. After 24 hours, the Misoprostol is taken, which relaxes and opens the cervix and causes contractions in the uterus, helping to expel the pregnancy from the body. Medical abortion is a process that can take up to 2 weeks or even until your next menstruation to be completed, but most women return to their daily routines after 1-2 days.

We strongly advise you to hold the Misoprostol under your tongue to ensure no remains can be found in your system. In the event you need to seek medical attention, Misoprostol will not show up on any blood tests and therefore there is no way to prove you have tried to terminate your pregnancy.

A medical abortion done in the first trimester is proven to be 98% effective and is considered safer than regular childbirth or using over the counter medicines such as ibuprofen and high-dosage aspirin. Both medicines, Mifepristone and Misoprostol, can be found on the WHO’s Core Model List of Essential Medicines.

Please read more comprehensive instructions and information on how to use the abortion pills by clicking here.

Medical abortion with only Misoprostol (Cytotec)

A medical abortion can also be done using only Misoprostol if Mifepristone is not available. When used as recommended, abortion with Misoprostol is 85% effective, depending on the length of the pregnancy. Misoprostol is available at some local pharmacies and this may be a safer option to terminate your pregnancy as you’ll have faster access to the medication. In order to self-manage an abortion up to 12 weeks using only Misoprostol, you will need 12 tablets within a 6-7-hour period.

If you are only using Misoprostol to do an abortion, it is important you know how far along you are. If you do an abortion using only Misoprostol after 12 weeks, the risk of heavy bleeding, severe pain, and/or complications increases the further into your pregnancy you are (similar to using Mifepristone and Misoprostol after 12 weeks) You can calculate how far along you are by getting an ultrasound (the more accurate method) or counting from the first day of your last period up to today. To visit our Pregnancy Calculator, please click here.   

Please read more comprehensive instructions and information on how to do an abortion using only Misoprostol by clicking here.

Medical Abortion After 12 Weeks

Several reasons contribute to the need for late abortions (12-24 weeks). Learning you’re pregnant in the second trimester because of irregular periods, mandatory waiting times causing delays, or simply changing your mind because circumstances have changed, are all valid reasons. Although late abortions account for a minority of cases, providing safe access to late abortions can reduce morbidity and mortaility related to abortions.

Women on Web’s service is only available until the 10th week of pregnancy, allowing sufficient time for the prescribed medicines to arrive. 

If you are taking the pills after 12 weeks due to delays in receiving the package, we strongly recommend that you situate yourself close to a healthcare facility. Research has shown that medical abortions done during the second trimester are also successful and the medicines will still cause an abortion. The risk of complications does, however, increase and it is more likely that you will need to receive medical attention afterwards.

A medical abortion after 12 weeks is always a safer option than resorting to unsafe methods to induce an abortion. Methods such as inserting sharp objects into the vagina, drinking or inserting toxic chemicals, or trauma to your abdomen are extremely dangerous and can be fatal. 

*If you are located in Poland, Women on Web will provide free abortion pills to those wanting to terminate a second trimester pregnancy with fetal abnormalities. 

Pregnancy calculator

Many people can tell they are pregnant based on various changes in their body. Early symptoms can include missing a period (while you are sexually active), nausea, sore and swollen breasts, and fatigue. 

The only ways to be immediately certain you are pregnant, however, is from a pregnancy test (accurate only from the first day of your missed period) or an ultrasound (shows pregnancy from about a week after your missed period).

Studies have shown that women can accurately estimate this by themselves. In order to calculate approximately how far into your pregnancy you are, try to remember the first day of your last period and count the days up to today; this should tell you with relative accuracy how far along you are.

If you think you are pregnant and would like to use our pregnancy calculator, please click here. If you are in need of an abortion with pills, Women on Web can help you up to 10 weeks of pregnancy. Click here for our consultation. 

Side Effects, Complications, and Risks

A medical abortion, or abortion with pills (Mifepristone and Misoprostol), is a safe and effective (98% efficacy rate) way to end a pregnancy. The side effects are the same as if you were to have a spontaneous miscarriage. Less than 0.4% end in serious complications. There are some health risks and side effects to consider but medical abortion is a widely-tested and modern health care service used by millions of women around the world.

What to expect (side-effects)

After inducing an abortion with pills, you can expect cramping, abdominal pain, bleeding, and the passing of blood clots and tissue. You may also experience nausea, vomiting, headaches, dizziness, diarrhea, and hot flashes or fever. Bleeding is often the first sign that the abortion has started. The bleeding will then continue and cramps will become more severe. A medical abortion can feel like a heavy period. The longer the pregnancy, the heavier the cramps and the bleeding will be. The heaviest bleeding usually stops 1 to 2 hours after passing the pregnancy tissue. 

To ease discomfort, you can take painkillers (NSAIDs) like Ibuprofen or Diclofenac before you do the abortion.

If any of these symptoms feel extreme or continue for several days after taking the Misoprostol, you should seek medical attention.   

For more details please visit our Q&A pages.

Recognizing complications

The risk of developing a complication from a medical abortion is very low (less than 0.4% end in serious complications). This risk is about the same as if you have a spontaneous miscarriage and it is treated the same way. Signs you may have a complication after the abortion are:

Heavy bleeding

If your bleeding lasts for more than two hours and soaks 2 or more maxi sanitary pads per hour, or you begin to feel dizzy or faint (this is a sign of too much blood loss), you should seek immediate medical care. Extra medication or sometimes surgery (vacuum aspiration) may be needed to treat heavy bleeding, but usually an additional dose of Misoprostol will stop the bleeding. In very rare cases (less than 0.2%), a blood transfusion may be needed. 

If you do need to seek further medical care, when going to the hospital and if available, put the remaining 2 tablets of Misoprostol under your tongue to help with the bleeding. Remember to swallow them or spit them out before entering the hospital.

High fever

A high fever may be a sign of an infection. It’s common for a mild fever (under 100.4 F/38 C) to develop within 24 hours of taking the pills but if the fever worsens or continues beyond a day or two, you may have a complication. If this is the case, you should seek medical attention as you may need antibiotics or vacuum aspiration to remove the infected tissue. 

Allergic reaction

Allergic reactions can occur after taking the abortion pills. Some common mild allergy symptoms include itchy skin, a rash, or an outbreak of hives (itchy bumps that develop on the surface of the skin). These reactions will either clear up themselves or can be treated with antihistamines. If you experience more severe reactions such as swelling, shortness of breath, dizziness, fainting, or pressure on your chest, you should seek immediate medical attention.   

If you experience any of these symptoms, you should seek follow-up medical care.     

For more details please visit our Q&A pages.

What happens if the abortion pill doesn't work?

A medical abortion with Mifepristone and Misoprostol is 98% effective and has the same health risks as having a spontaneous miscarriage. There are some potential risks, however, that you should keep in mind. 

On-going pregnancy

One risk is the abortion may not terminate your pregnancy. If you continue to experience pregnancy symptoms after taking the pills, such as nausea or tender breasts, you may have an on-going pregnancy. It’s recommended you do a pregnancy test after 3 weeks to confirm you are no longer pregnant. It’s important you wait for at least three weeks before you do the test. Your body could still have pregnancy hormones that could yield a false positive. 

Incomplete pregnancy

Another risk is you could have an incomplete abortion. This means the pregnancy is terminated but there are still remains left in your uterus. If the remaining tissue stays in your body, you could develop complications such as heavy bleeding or an infection. If you have abdominal pain that does not go away after a few days, severe pain, too much bleeding (more than a regular period), fever, or prolonged bleeding, you may have an incomplete abortion. Three weeks after the abortion you may also continue to get positive pregnancy tests if the abortion is incomplete.  In this case, you should have an ultrasound done to verify there is no remaining tissue left in your body. If you do not have any signs of a complication, you can take two more tablets of Misoprostol to expel the remaining tissue. 

Ectopic pregnancy

Lastly, the abortion pills will not work if you have an ectopic pregnancy. An ectopic pregnancy is when the fetus is located outside of the uterus (usually in the fallopian tubes). In this case, the pills will not be effective and you will need to seek medical attention. Ectopic pregnancies are rare but can lead to serious health risks and need to be treated right away. If you experience severe or on-going pain after the abortion, particularly on one side, you may have an ectopic pregnancy. It’s important to check that your pregnancy has ended with a pregnancy test after three weeks. If your test is positive, it’s important to get a medical checkup as you may have an ectopic pregnancy.  

For more details please visit our Q&A pages.

Medical vs. Surgical abortion: What’s the difference?

There are two types of safe abortion methods: surgical and medical. A surgical abortion is a minor procedure that removes the pregnancy through surgical means. The recommended and most common in-clinic procedure is called vacuum aspiration. It is performed by a trained healthcare provider and requires a visit to the clinic.

A medical abortion is an abortion with pills. Many women choose this method as it is less invasive and requires no anesthesia or instruments. The process can be self-managed at home making it more private option, and some say it feels more natural as it resembles a heavy period or miscarriage. At-home abortions reduce the need to travel and schedule around childcare and work commitments, resulting in earlier, safe and less intrusive abortions.

In some countries, only surgical abortions are available but access to both options is an essential and time-sensitive health care need.

Unsafe methods and remedies for abortion

The World Health Organization (WHO) has stated self-managed or home abortions is a safe and effective option. The internet, however, often offers information on home methods that have been falsely reported to be safe. While some remedies may seem enticing, such as natural or inexpensive products around the house, you should avoid using these methods to terminate a pregnancy. They are not effective and can pose serious health risks. Complications with various home remedies could include an incomplete abortion, infections, hemorrage, or even life-threatening consequences. 

In areas where abortion is illegal or restricted, women will often resort to unsafe methods to terminate their pregnancy. According to the WHO, as much as 45% of all abortions performed globally are unsafe. The only methods that have been found to be safe and effective are medical and surgical abortions. You should never ingest caustic or toxic solutions, insert sharp objects into your body, or self-harm to end a pregnancy. If you need an abortion, click here for our consultation.  

Some home remedies to avoid are:

Teas and herbs

Some alternative home abortions may seem safe, such as using natural herbs and teas. Unfortunately, these methods may carry additional health risks and could be toxic. Even common herbs and spices you use daily can pose health risks if used improperly.

Herbal remedies commonly advised to induce an abortion/miscarriage are referred to as herbal abortifacients or emmenagogues. These are herbs or plants that are often believed to stimulate menstruation, encouraging the uterus to contract and expel its contents. Some common abortifacients are wormwood, yarrow, safflower, peony, chamomile, mugwort, and herbs high in essential oils. Fruits, berries, and even vitamin C are also commonly believed to induce an abortion. The effectiveness of herbs and plants to induce an abortion, however, is highly disputed and most require a toxic amount to be taken to have the desired effect. Taking these remedies to end a pregnancy pose high health risks that will often require medical treatment and are not reliable abortion methods.  

Household tinctures or chemicals

Chemicals or solutions found around the house should never be used to induce an abortion, no matter how harmless they may seem. Homemade tinctures or concoctions could be toxic and require immediate medical attention.   

Using chemical solutions such as cleaners or bleach is extremely dangerous and should never be attempted.  

Painkillers, prescription, or over-the-counter medication

You should only use medication found at home as directed or as prescribed by a medical professional. Using any medication that is not intended to induce an abortion could have serious health risks. 

If you’re thinking of ending a pregnancy with abortion pills you should always be aware of fraudulent retailers posing as legitimate services. Selling fake pharmaceuticals is not uncommon, especially on the Internet, and abortion pills are no exception. Make sure you do some research before you purchase or order abortion pills to verify they are coming from a trustworthy source.   

Read Women on Waves’ warning on fake online pharmacies here.

For more information on unsafe abortion, click here.

Abortion Laws

Abortion laws across the globe vary from total bans on abortions to having abortion services available on request. Even in countries where abortions are prohibited/ illegal or only allowed to save the life of the woman, abortions still occur. In fact, the rate of unintended pregnancies is the highest in countries where abortion access is restricted.

You can visit the World’s Abortion Laws database to check the legal status of abortion in your country.

The two medicines that make up the abortion pill, Mifepristone and Misoprostol, are both listed on the World Health Organization’s Core Model List of Essential Medicines. This list contains medicines considered critical to meet the most basic needs of any public health care system. The World Health Organization recognizes abortion as a public health issue and supports the use of the abortion pill as a safe and effective way to terminate a pregnancy. 

You can read more about abortion services and support available in your country here.

 

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