How does the Abortion Pill work? The term “Abortion Pill” refers to two types of pills containing different chemicals: mifepristone and misoprostol.
The abortion pill (aka medical/chemical abortion) is currently the fastest-growing form of abortion in the United States today. This article outlines what a medical abortion is, how it works, the FDA, warning signs, abuse and how a chemical abortion can be stopped through abortion pill reversal. Information is critical for everyone to understand more about this drug some refer to as healthcare.
Key Takeaways
- How Does the Abortion Pill Work
- 1st pill: Mifepristone – How it Works
- 2nd pill: Misoprostol – How it Works
- Risks / Warning Signs
- Emergency Visits up 11%
- Ectopic Pregnancy and the Pill
- Ordering Abortion Pill Online
- The Generic Pill
- Concerns about FDA Approval
- Mental Health and Abortion
- Seeing the Fetus After an Abortion
- Abuse of the Abortion Pill
- Abortion Pill Reversal
- Summary
How Does The Abortion Pill Work?
So, how does the abortion pill work? Ultimately, a medical abortion occurs after taking two different types of pills. Each pill contains a different medicine.
Mifepristone
(Mifeprex) blocks progesterone, a hormone essential for a healthy pregnancy. Originally called RU-486, it was approved for abortion in 2000. Since then, the generic name mifepristone or the trade name Mifeprex (also known as Cytotec) has been used.
According to the Mayo Clinic, Mifeprex blocks progesterone, the hormone that sustains and nourishes a developing embryo. Without progesterone, the uterine lining thins, the blood supply decreases, and oxygen and nutrients to the embryo are cut off.
- The first pill is taken orally. Abortion providers suggest taking something for pain before starting the first pill.
What does mifepristone do to the embryo? Mifepristone blocks the effects of progesterone, the female hormone vital for pregnancy. This essential hormone causes the placenta to adhere firmly to the uterine lining. A very close connection between the placenta and the lining of the uterus is essential for the embryo, and later fetus, to receive oxygen, water, and nutrients. By blocking progesterone, mifepristone has several effects, most notably the separation of the placenta from the uterine lining. With that, the lifeline is cut—fluid and nutrition can no longer reach the preborn baby. This is the primary cause of the death of a preborn baby during a mifepristone chemical abortion.
Misoprostol
The second medication, misoprostol pills are taken 24–48 hours after mifepristone. It softens the cervix and causes uterine contractions, expelling the baby and pregnancy tissue from the uterus. In short, misoprostol induces early labor.
- Works similarly to induced early labor or miscarriage.
- These four pills, or more, are taken buccally, sublingually or vaginally (though vaginal use has an increased risk of Clostridium sordellii infection).
- Conflicting reports on the severity of cramping and blood exist.
Together, these pills work to stop the growth of pregnancy before inducing labor. Dr. Lile (board-certified in obstetrics and gynecology) discusses medical abortion. Moreover, he discusses why many abortion providers don’t disclose this information to their clients:
More Interviews with Dr. Lile:
What to Expect When Taking the Abortion Pill
The process of a chemical abortion unfolds in three stages:
- Step 1: A woman gets the first pill, sometimes from a clinic that watches her take the pill and sometimes through the mail. She takes the pill.
- Step 2: Common symptoms begin shortly after taking the first pill, including:
- Severe abdominal cramping usually within 2–6 hours, though it can take longer.
- Heavy bleeding for several hours after the first pill is taken. Pads are recommended to track blood loss and clotting.
- There is pain and sometimes nausea.
- Step 3: 24-48 hours later, Misoprostol is taken at home.
- 90% of women describe the pain as moderate to severe, and half of them say it is worse than they expected.
- Passing clots, tissue and embryo. Some women report seeing the intact baby.
- Vaginal bleeding or spotting for 9-16 days. 8% of women bleed for 30 days or more.
- Anxiety
- Blurred vision
- Chills
- Cold sweats
- Coma
- Confusion
- Cool, pale skin
- Depression
- Dizziness
- Fast heartbeat
- Headache
- Increased hunger
- Nausea
- Nervousness
- Nightmares
- Seizures
- Shakiness
- Slurred speech
- Swelling
- Unusual tiredness or weakness
I Took the Abortion Pill - 7 1/2 Weeks Pregnant
by Rebekah Hagan with Suzanne Gosselin
I sat in my car, tears streaming down my face. I had just walked out of Planned Parenthood after taking the “abortion pill.” Initiating a chemical abortion had been simple—check some boxes regarding my medical history and sign my name a few times, affirming I wanted to have the abortion. In a small exam room, I swallowed the mifepristone pill (also called RU-486) in front of a watching nurse.
Back in my car, I rummaged through the brown paper bag I’d received, containing the pills I would use to complete my abortion 24 hours later. The second medication, misoprostol (also known as Cytotec), would induce active labor, causing my body to expel what they’d referred to as a “pregnancy.”
“The process will be very natural,” the nurse had explained, “much like your regular menstrual cycle. You should only be concerned if you are passing blood clots larger than the size of a lemon.”
Large Blood Clots
Her words replayed in my mind, and fear seized my heart. Blood clots as large as my fist? Suddenly, I had another horrible thought. Exactly one year earlier, I had been in active labor with my oldest son. Tomorrow, the day I planned to complete my abortion, would be his first birthday.
I’m never going to be able to forget this day, I thought. It would be a day commemorating joy and heartbreak—joy over bringing one baby into the world and heartache overtaking another one out of it.
Difficulty With Family
I grew up the youngest of four sisters in a conservative Christian home. There were unspoken expectations for moral behavior and refraining from sex before marriage. An unplanned pregnancy with a boyfriend did not fit within those expectations. Because my parents and I never had those tough conversations, I didn’t view them as authorities on those subjects. At 17, I found I was pregnant. Despite my fear of the unknown, I had hope and chose life for my baby.
When faced with the reality that their baby was having a baby, my parents were shocked and angry. The anger eventually turned to support, though my dad made it clear that a repeat occurrence was not an option. This was a one-time extension of grace, and I could not let it happen again. With their help, I graduated from high school, delivered my son and began college at a local university. Things seemed to be looking up, at least on the outside.
Unsafe Relationship
Behind closed doors, my on-again-off-again relationship had become abusive and unsafe and I knew it had to end. Living under my parents’ roof, I started life as a single mom. However, just a few days after ending that abusive relationship, I discovered I was pregnant again. This time, I had no hope. I went into crisis-survival mode and convinced myself to take swift action before anyone discovered my secret.
The narrative surrounding chemical abortion is that it’s a simple, convenient solution to an unwanted pregnancy. “Take these pills, and your pregnancy—and your problems—will magically go away.” Desperate for a way out, I believed it was a compassionate, responsible choice.
So far, I’d defied the odds, finishing high school and getting into college. My parents were proud of me, and I had just regained their trust. I believed the news of another unplanned pregnancy would cost me my education, my dreams and even my family.
You Versus the Baby
I was desperate to preserve the life I was creating for myself and my almost 1-year-old son, and I questioned the quality of life we would have if I brought another child into this world. I envisioned us being alone, broke and homeless, and my children growing up without a father. Amid this panic, the abortion industry pitted me against my own child, telling me I had to choose between the two.
A Choice, A Regret
I had fewer than two weeks remaining to choose a chemical abortion. I was warned that if I didn’t decide quickly, time would run out, and a surgical abortion—something I knew I could never go through with—would be my only option.
Believing hope was waiting on the other side of this choice, I swallowed the first abortion pill. Only moments later, regret set in. I was angry at myself and felt duped. I sensed this was bigger than an abortion doctor misleading me; this was a battle of good versus evil, light versus darkness. I had been walking down a dark path, looking for anything that appeared to be light and hope. I had followed what I’d mistakenly thought was light and made my choice. And in that moment, it was as if Satan blew out the candle and said, “Gotcha! Now you’ll know shame, grief and regret for the rest of your life.”
I suddenly understood how far I had strayed. But there was no going back. If I didn’t take the second set of pills, the abortion clinic doctor had said, there would be a risk of fetal anomalies.
“Lord,” I prayed, “please help me find a way out of this. Even if there is no way, please forgive me, and help me to forgive myself.”
A Way of Escape
After I prayed, I began searching the internet for what to do if I didn’t want to complete my chemical abortion. I scrolled through pages of search results until I came across an advertisement that offered hope and the possibility of reversing the effects of the abortion pill, a protocol called Abortion Pill Reversal (APR). The website had just launched, and the information was new. I didn’t know what to expect, but I was desperate for a chance to save my baby.
I called the number and spoke to a kind nurse manager at a pregnancy center. I’ll never forget the compassion in her voice as she asked questions about what had led me to this point. She began to explain how the abortion pill works, and I was shocked. I hadn’t been told any of the details.
What is Abortion Pill Reversal?
“The pill you took is designed to deprive your body and your baby of progesterone,” she explained. “If we can get progesterone back into your body, there is a chance your pregnancy can continue, and you can give birth to a healthy baby.”
The center connected me with a doctor two hours away from my home in Northern California who could administer the protocol. Within 24 hours of taking the abortion pill, I started the APR progesterone regimen, which would last for several weeks.
When my parents found out about my second pregnancy, they were as angry as I expected. But my dad’s wrath softened when he learned that I could have been upstairs in his own home aborting his grandchild. Both of my parents were shocked to learn they had been cut out of the equation. That shock turned to compassion and, eventually, support. Though there were no guarantees, the abortion pill reversal protocol was effective, and in October 2013, I gave birth to a healthy baby boy.
Women Like Me
Through my story, the Lord put me on a path to serve in the pregnancy-help field. Over the past decade, I’ve dedicated myself to this mission, working in pregnancy centers and pro-life nonprofit organizations. I’ve met women facing situations like mine and noticed a gap between those women and the supporters who sustain these valuable ministries. I observed that even well-meaning believers didn’t fully understand who was walking through our doors and why.
Our pregnancy center clients weren’t primarily women from low-income areas lacking education or a Christian upbringing. These were women like me from local churches and families. Through sharing my story, I was able to say, “I’m not an exception. This is happening in our community, and we need to approach the abortion issue with compassion and conviction.”
What is a Chemical Abortion?
Chemical abortion, also known as the abortion pill, which is not carefully regulated and can pose health risks to the mother, is marketed as safe, convenient and affordable. With widespread accessibility through telehealth and mail-order pharmacies, chemical abortions now make up 63% of all U.S. abortions. Young, vulnerable people are being deceived, and the lives of preborn children are at risk.
Today, I speak frequently at churches and on behalf of pregnancy help organizations about chemical abortion and Abortion Pill Reversal. Through my story, I seek to illuminate the mindset of women experiencing unplanned pregnancies, the lies the industry is telling them and how pregnancy centers provide a lifeline to these women and their babies. The pain of an unplanned pregnancy brought me to the pregnancy-help field, but passion has kept me here. I will continue to use my story of a second chance at choice, to glorify God and help others choose life.
Risks of the Abortion Pill
Incomplete abortion or retained tissue is a risk. Around 2-4% of women need a surgical procedure or additional doses of the abortion pill because the abortion was not complete.
- One review of 45,000 chemical abortions found that almost 5% failed, requiring surgery, and 1% did not terminate the baby’s life.
- A second review of 18,000 cases found nearly 8% failed in the first trimester, and almost 40% failed in the 2nd trimester.
- Heavy bleeding (may require a D&C)
- Mifepristone also inhibits contraction of uterine blood vessels, predisposing to hemorrhage with possible transfusion needed.
- Allergic reaction
- Digestive issues
- Infection: fever >24–48 hours or foul odor
- Some women report psychological after-effects such as depression or PTSD, though experiences vary.
- The side effects of cramping, vaginal bleeding, nausea, weakness, fever, chills, vomiting, headache, diarrhea, and dizziness occur in 99% of patients, which are likely to contribute to the higher rates of psychological distress associated with chemical abortions, as does the possibility of being exposed to a view of the aborted fetus.
- Another study surveying volunteers a few hours and six weeks after their abortions found that 38% of the women had symptoms of post-traumatic stress disorder (PTSD) and that the risk was significantly greater after a chemical abortion compared to a surgical abortion. These findings are consistent with the theory that chemical abortions are more psychologically stressful because women are more likely to see blood and products of conception. By taking the medication directly, women cannot shift blame for the abortion to the surgeon who “did it” to them, and the abortion process is much more prolonged.
- When the FDA loosened its restrictions in 2016, allowing the gestational age limit to be extended from 7 to 10 weeks, the predictable increase in failure rates followed, rising from a 2% failure rate before 7 weeks to 7% by 10 weeks.
Warning Signs Requiring Immediate Care
With this in mind, more severe symptoms may occur. These symptoms may be signs of life-threatening issues. While tough symptoms are a part of the medical abortion process, a client should contact a professional immediately if they experience:
- Heavy bleeding that soaks through two thick, full-sized sanitary pad per hour for two hours
- Persistent or worsening stomach pain or discomfort
- Weakness, dizziness or fainting
- Vomiting
- Diarrhea, with or without fever
- Fever of 100.4° or higher for more than four hours.
The Abortion Pill is NOT as Safe as Tylenol
Tylenol is very different from the abortion pill. Therefore, it seems ludicrous to compare the two. However, no studies have compared the safety of the two. So, let’s not say things we do not know.
However, there has been a study that reviewed 865,727 insurance claims from 2017 to 2023, where women reported taking the abortion pill.
- Of those women,10.93% experienced sepsis, infection, hemorrhaging or another serious adverse event within 45 days following a mifepristone abortion.
- The higher risks associated with Mifepristone/misoprostol abortions may result from potent suppression of the immune system by both medications, thereby increasing the risk of infection and possible sepsis. Mifepristone also inhibits contraction of uterine blood vessels, predisposing to hemorrhage with possible transfusion. If the pregnancy tissue is not completely expelled, there is an increased risk of both hemorrhage and infection, and this often requires surgical completion.
- The real-world rate of serious adverse events following mifepristone abortions is at least 22 times as high as the summary figure of “less than 0.5 percent” in clinical trials reported on the drug label.
- A record linkage study of all abortions in Finland (surgical n=20,251, medical n=22,368) found that 20.0% of women undergoing mifepristone-induced abortions experienced adverse events, including 15.6% suffering hemorrhage, 5.9% requiring surgical intervention, and nine deaths per 100,000 abortions.
- 1 in 20 women needs emergency care. It often takes 3 ER visits before the needed care is obtained. A large part of the multiple visits is the advice women are given to say it is a miscarriage and not a medical abortion. This does not give the physician the information they need. It is not illegal in any state to help a woman with a botched abortion. Misdiagnosing an abortion as a miscarriage (which happens 60% of the time) increases the risk of multiple hospitalizations and surgeries.
How the Abortion Pill Works
As review, the abortion pill is actually a combination of two pills – mifepristone and misoprostol.
When a woman is pregnant, her body releases a hormone called progesterone. It’s her body’s way of seeing the pregnancy and coming in to support it and keep it healthy. The first of the two-pill regimen – mifepristone – blocks the effects of the progesterone. This essentially cuts off nutrients to the fetus and stops it from growing.
With the pregnancy still in the uterus, the second pill (taken the next day) causes large contractions. This sets in motion what some doctors call “early delivery” and is similar to those of a miscarriage. Because the process is so intense, having an at-home abortion through the pill can be overwhelming.
Abortion Pill Online Safety
There are a few key differences in getting the abortion pill online versus in a doctor’s office. For one, there are risks that come along with not having an in-person visit before getting the pill, such as not knowing the gestational age of the fetus. Another con is not having a doctor in person to check in through an emotionally and physically heavy process.
Risks of At-Home Abortion
By skipping an in-person exam, risks increase, such as:
- Dating a pregnancy incorrectly, which risks severe complications if taken after the 10-week limit from the FDA.
- Having an ectopic pregnancy, which risks missing the window for potentially life-saving treatment.
- Isolation during a traumatic procedure, which risks depression and suicidal thoughts (these are already extremely high after an abortion) and encourages a woman to go through it alone.
- Not seeing an ultrasound, which risks pressure into an abortion decision without knowing what’s going on in a woman’s body
Possible Complications of At-Home Abortion
The safety of the abortion pill online is minimal at best. While removing mandatory doctor’s appointments can be convenient, it also removes essential medical services from the abortion process. For example, someone can test positive on a pregnancy test but not know they have an ectopic pregnancy – which is dangerous and potentially life-threatening. Forgoing an ultrasound and having an at-home abortion leaves a big risk of missing an ectopic pregnancy and not getting life-saving treatment in time.
Additionally, abortion complications are very common with the pill – about one in three women experience mild to severe physical side effects. In fact, the abortion pill actually has four times the amount of complications than surgical abortion. The abortion pill process should have more medical supervision, not less.
And this doesn’t even include psychological side effects: depression, nightmares and regret follow roughly one-third of abortions. There is also a double risk of suicide and five times the risk of substance abuse compared to someone who miscarries. Experiencing such a physically and emotionally heavy procedure alone would make it even harder than it already is and has the potential to harm your physical, emotional and mental health.
Preparing to Take the Abortion Pill Online
If you’re considering the abortion pill online, there are a few simple steps to start with. Though it may feel like a rush, you have time to ensure your health and safety.
First, go to a clinic and confirm the pregnancy. Pregnancy medical clinics offer pregnancy testing free of charge, and can usually fit you in the same day.
The next step is getting an ultrasound. This is by far the most important step before ordering the abortion pill online. Not only will it ensure the pregnancy isn’t ectopic or abnormal, but it is also a window into what is going on in your body. Women often feel hesitant to look and listen when seeking an abortion, but having all of the information will help you make the best possible decision.
After that, seek counseling. It’s okay to slow down and talk through the options because though it seems simple, ordering the abortion pill online, it comes with a lifelong impact.
We suggest going to your nearest pregnancy medical clinic as a first step. They can provide all of the above services and can typically fit you in the same day. They are nonprofits dedicated to helping women with unexpected pregnancy, and therefore don’t charge for services. Find the nearest pregnancy clinic here. If you aren’t ready to go to a clinic but still want to talk to someone, you can call us at 1-800-A-FAMILY to chat about options and how you’re feeling.
Abortion Pill Reversal
If you have only taken the first abortion pill, reversal is possible! The process begins by contacting a medical professional who has been trained in the reversal process. Equally important is how quickly you seek help. With this in mind, the earlier you contact a medical professional, the better.
A medical professional in your area can be found via the abortion pill reversal hotline: 1-(877)-558-0333.
Many lives have been saved through abortion pill reversal. It’s safe, effective, and ministered under the care of a medical professional.
