Do I need an ultrasound before having an abortion with pills?


Authored By: Suzanne Veldhuis

Authored On: 15/03/2026

Reviewed By: Dr. Louise Gilbert

Reviewed On: 15/03/2026

No. Ultrasounds are not necessary before abortion pills. Most people can estimate how long they’ve been pregnant on their own. They don’t need ultrasounds to do that.

We recommend ultrasounds in some cases, such as when:

  • Your last 3 menstrual cycles were irregular.
  • You’re breastfeeding/chestfeeding and haven’t had your period return yet.
  • You’ve been using hormonal contraceptives
  • You have signs of an ectopic pregnancy

Ultrasounds before abortions with pills give some people reassurance. If that’s the case for you, that’s a valid reason to have one.

Sources

  1. World Health Organization. 2022. Abortion Care Guideline. https://apps.who.int/iris/handle/10665/349316
  2. World Health Organization. 2023. Clinical Practice Handbook for Quality Abortion Care. https://www.who.int/publications/i/item/9789240075207
  3. Duncan, Clara I., John J. Reynolds-Wright, and Sharon T. Cameron. 2022. ‘Utility of a Routine Ultrasound for Detection of Ectopic Pregnancies among Women Requesting Abortion: A Retrospective Review’. BMJ Sexual and Reproductive Health 48 (1): 22–27. https://doi.org/10.1136/bmjsrh-2020-200888
  4. Raymond, Elizabeth G., Daniel Grossman, Alice Mark, Ushma D. Upadhyay, Gillian Dean, Mitchell D. Creinin, Leah Coplon, et al. 2020. ‘Commentary: No-Test Medication Abortion: A Sample Protocol for Increasing Access during a Pandemic and Beyond’. Contraception 101 (6): 361–66. https://doi.org/10.1016/j.contraception.2020.04.005
  5. Schonberg, Dana, Lin Fan Wang, Ariana H. Bennett, Marji Gold, and Emily Jackson. 2014. ‘The Accuracy of Using Last Menstrual Period to Determine Gestational Age for First Trimester Medication Abortion: A Systematic Review’. Contraception 90 (5): 480–87. https://doi.org/10.1016/j.contraception.2014.07.004
  6. Saavedra-Avendano, B, R Schiavon, P Sanhueza-Smith, R Rios-Polanco, L Garcia-Martinez, and BG Darney. 2017. ‘Assessment of Gestational Age among Women Seeking First-Trimester Abortion in Mexico City: A Comparison of Last Menstrual Period and Ultrasonography Estimation’. Contraception 96 (4): 277. https://doi.org/10.1016/j.contraception.2017.07.059
  7. Raymond, Elizabeth G., and Hillary Bracken. 2015. ‘Early Medical Abortion without Prior Ultrasound’. Contraception 92 (3): 212–14. https://doi.org/10.1016/j.contraception.2015.04.008
  8. Bracken, H., W. Clark, E. S. Lichtenberg, S. M. Schweikert, J. Tanenhaus, A. Barajas, L. Alpert, and B. Winikoff. 2011. ‘Alternatives to Routine Ultrasound for Eligibility Assessment Prior to Early Termination of Pregnancy with Mifepristone-Misoprostol’. BJOG: An International Journal of Obstetrics and Gynaecology 118 (1): 17–23. https://doi.org/10.1111/j.1471-0528.2010.02753.x
  9. Aiken, Ara, Pa Lohr, J Lord, N Ghosh, and J Starling. 2021. ‘Effectiveness, Safety and Acceptability of No‐test Medical Abortion (Termination of Pregnancy) Provided via Telemedicine: A National Cohort Study’. BJOG: An International Journal of Obstetrics & Gynaecology 128 (9): 1464–74. https://doi.org/10.1111/1471-0528.16668

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