A medical abortion (also known as abortion with pills) involves taking two types of medication to end a pregnancy: mifepristone and misoprostol.
In this blog, we provide information on:
- How to take mifepristone
- How to take misoprostol (by mouth or vaginally)
- Whether you can take misoprostol at night or in the morning
- Medical abortion aftercare
How to take mifepristone
The first medication that is taken as part of a medical abortion is called mifepristone. This blocks the hormone needed for the pregnancy to grow.
Once you receive the pack, take your first tablet (1 mifepristone tablet). Remove only the mifepristone from the blister pack (or from your plastic bag labelled “1” if you receive the package by post) and swallow it with plenty of water.
Most people can continue their daily routine as normal after taking mifepristone. Occasionally you may experience some bleeding and pain.
If you vomit within 30 minutes of swallowing the tablet, call our 24-hour aftercare line on 0345 122 1441.
How to take misoprostol
The second medication that is taken as part of medical abortion care is called misoprostol. This causes the body to expel the pregnancy from the womb.
The tablets work best if you leave 24-48 hours between the first and second steps, but you can take them up to 72 hours after (please note that if more than 72 hours pass and you have not taken the misoprostol tablets you may need to come back to the clinic to repeat the treatment).
24-48 hours after completing step 1, remove the 4 tablets of misoprostol from the blister pack (or from your plastic bag labelled “2” if you receive the package by post). Place all 4 tablets either vaginally (which we recommend as there are fewer side-effects), or if you prefer in your mouth between your gum and cheek.
You can take your chosen method of pain killers 10 minutes before you plan to take the misoprostol.
The tablets might come out of the vagina when you start to bleed. If the tablets come out at this point, don’t worry as the medication will have been absorbed within 30 minutes.
Please remember that if you are 9 weeks and 6 days gestation on the day of taking the first tablet (mifepristone) you must take this second set of tablets (misoprostol) no more than 24 hours later.
How to take misoprostol vaginally:
- Empty your bladder.
- Wash your hands.
- Using your finger, push the misoprostol tablets up into the vagina one at a time. Insert them as far as you can.
- Please try to lie down for at least 30 minutes to ensure the tablets don’t come out of your vagina.
- If tablets fall out in the first 30 minutes, re-insert them. Please note that the tablets might come out of the vagina when you start to bleed. If the tablets come out at this point, don’t worry as the medication will have been absorbed within 30 minutes.
How to take misoprostol by mouth:
- Put 2 misoprostol tablets on each side of your mouth between your cheek and gums.
- Keep them in your mouth for 30 minutes.
- After 30 minutes, you can swallow any undissolved tablets with water. The tablets may leave an unpleasant taste in your mouth.
3 hours after taking these 4 tablets of misoprostol, take the remaining 2 tablets of misoprostol unless you are sure you have already passed the pregnancy.
For detailed instructions on how to take misoprostol by mouth or vaginally, including diagrams, read our medical abortion treatment and aftercare booklet.
Can I take misoprostol at night or in the morning?
As long as you take the misoprostol tablets as directed by the nurse or midwife during your appointment, it is up to you at what time of the day you take misoprostol. You can take the tablets at any time of the day – at night, or in the morning – but you may start to experience bleeding and cramping pains within a few hours of taking the misoprostol, so you may want to consider this when choosing the right time for you.
The abortion is usually completed within 1-2 days, but occasionally, it can take up to 2 weeks to fully pass all the pregnancy tissue, and you may continue to bleed for up to 8 weeks.
Most people will experience significant cramping pain and will find pain relief helpful. Pain relief should be taken before you take the misoprostol, or if preferred when you start to feel cramps building up. You can find detailed guidance on pain relief at our medical abortion aftercare page, and in our medical abortion treatment and aftercare booklet.
We are here to support you should you have any questions when taking medical abortion pills. To talk to a nurse, you can call our dedicated aftercare line on 0345 122 1441 – this is available 24 hours a day, 7 days a week.
How to get in touch with us
We are here to support you should you have any questions when taking abortion pills. There are a number of ways you can contact us.
You can always get in touch should you have any questions about our services, would like to book an appointment or you have had treatment with us and want aftercare support.
