Step 1: After a health care provider determines that a medication abortion is safe and appropriate, a pregnant person will swallow one tablet of mifepristone, as prescribed. This blocks the hormone progesterone, a hormone needed to continue pregnancy. It makes the uterus contract, softens the cervix, and may cause bleeding. For a very small percentage of people, the pregnancy is passed at this stage.
Step 2: The health care provider will give the pregnant person a pack of 4 pills called misoprostol. It is important to keep these pills in a dark, dry, and cool place. After 24-48 hours of taking one tablet of mifepristone, the client will place 2 tablets of misoprostol into each cheek (4 tablets total). They will leave the pills in their cheeks for 30 minutes. After 30 minutes, any pills remaining in the mouth need to be swallowed. Some people experience nausea, chills, vomiting, fever, and diarrhea as side effects of misoprostol. If any of these last longer than 24 hours after taking misoprostol, call the Emergency On-Call number you were given at your appointment or proceed to the nearest emergency room.
Step 3: After taking the medication, cramps and bleeding will begin. The pregnancy is usually expelled between 30 minutes and 4 hours after taking the 4 pills of misoprostol. Expect heavy bleeding (usually heavier than a period), severe cramps, and passing clots. Some clots may be as big as a lemon. Cramps and bleeding will intensify as the pregnancy is being passed. After the pregnancy has passed, you can expect to feel a lot better. If you saturate 4 large pads in 2 hours, call the emergency number you were given at your appointment or proceed to the nearest emergency room. This might be too much bleeding.
Step 4: In the days following, the bleeding should slow down and the cramps should go away. If you are feeling feverish, sick, or if the bleeding continues or worsens, call the Emergency On-Call number you were given at your appointment or proceed to the nearest emergency room.