If you’re a parent considering an abortion, you may be wondering if that choice could put you at risk of a Child Protective Services (CPS) investigation. I Need An A and If/When/How want you to know that many parents decide to have an abortion because it is the best decision for them and their family. We want you to have all the information you need to feel supported, no matter what you decide to do.

Can CPS get involved if I have an abortion?

Having an abortion—whether at a clinic or self managing with pills—is not a reason to be reported to CPS. It is not a crime. But, in rare cases, especially when someone self manages or goes to the emergency room afterward, abortion has led to CPS involvement.

Let's be clear - healthcare providers do not have to report someone to the police or CPS for having an abortion, including a self-managed abortion. But what the law says and what happens in real life can be different.

Here are some ways CPS involvement can happen due to an abortion:

🚩 If a parent is reported to the police for self-managing their abortion, research shows that CPS will be called.

🚩 If a healthcare provider or clinic staff believe they need to make a call based on something shared during an appointment.

Healthcare providers and clinic staff are mandated reporters. This means they are legally required to report suspected child abuse or neglect. What is considered child abuse and neglect depends on the laws in each state. Though unlikely, this means there is a chance they might report you to CPS. The risk is higher if you talk about:

• struggling with housing, food or other basic needs
• Mental health or disability
• Drug use during pregnancy

🚩 People experiencing intimate partner violence can face a higher risk of being reported to CPS.

Sometimes, the abusive partner can make the report. Other times, hospital staff report that there are kids at home because they may believe the violence is putting your child at risk or that calling CPS will help get you resources to leave. But CPS getting involved often causes more harm than help.

If you are experiencing intimate partner violence and need help, call or chat with the National Domestic Violence Hotline.

🚩 If the person getting the abortion is a minor, particularly if they’re under 15 and going to a clinic.

Every state has statutory rape laws. These laws say people can only consent to sex after a certain age, no matter the age of the other person. Healthcare providers, including clinic workers, are mandated reporters and may be required to ask about how your teenager got pregnant. You or your teen don’t have to share any information about the other person involved if you’re not comfortable.

What rights do I have as a parent when CPS is involved?

You do not have to share any information to CPS about your abortion and/or medical history that you don’t want to share.

Do not sign any paperwork (“release” or “HIPAA form”) without talking to a lawyer first. You can tell them that this is private medical information that is protected by HIPAA and you don’t want to speak about it without talking to your lawyer first. If CPS contacts you and is asking you questions about your abortion, you can contact the Repro Legal Helpline at 844-868-2812.

You do not have to speak to CPS if you do not want to.

You also do not have to let them into your home without a warrant or court order signed by a judge. But that does not mean the investigation will stop or the case will end.

CPS may contact other people in your and your children’s lives, like family, neighbors, or teachers, for more information. They might also decide to get a court order saying that you must meet with them or let them see your children. Everyone’s situation is different, and only you know what is best for you and your family.

You do not have to let CPS talk to your child(ren).

If they are old enough to speak, CPS will probably try to talk to them alone. CPS may do this when they first come to your home, or they may go to their school. You can tell the school that you do not want CPS talking to your children without you. Or that they notify you if CPS contacts the school. But many schools have agreements with CPS that they will let CPS interview children at school without a parent. CPS may also decide to bring you to court so they can get an order from a judge that lets them talk to your child(ren) without your permission.

If you decide to talk to CPS, remember that everything you say and do will be documented by CPS and can be used against you in court later.

That means how you say something can be just as important as what you say to CPS. If CPS believes you’re being rude or defensive, that can impact their decision making in your case. Try to stay as calm as possible when talking to CPS.

How can I reduce my risk?

Be mindful of who you talk to about your abortion and how you communicate about it.

You do NOT have to tell anyone about your abortion.

• If you’re worried about going to the emergency room or hospital after an abortion or miscarriage, read this article.
• To learn about your rights when talking to any healthcare provider about your abortion or miscarriage, read this article.
• Learn more about how to keep your information private.
• To learn more about how immigration status can affect abortion access, read here.

Find free legal, medical and emotional support.

• Repro Legal Helpline: get all of your legal questions answered, including questions about CPS.
• M+A Hotline: get your medical questions answered by a volunteer doctor.
• Reprocare: Peer support hotline for people using abortion pills.
• Aya Contigo: A digital companion for sexual and reproductive health care with a live chat.

FAQ

Abortions are safe and common—and you shouldn’t have to fear legal consequences or losing your children because of decisions about your body and your family. We hope this article helped you feel more prepared and supported. You always have options, and you’re never alone.

Find your abortion options at ineedana.com, and get your legal questions answered by the Repro Legal Helpline 💜 Want to hear from people who were already parents? Check out this collection of their stories.

Maybe! It really depends on a few things:

• If you have a negative blood type
• If you’re having an abortion or miscarriage after 12 weeks of pregnancy
• If you want to have children in the future

If you answered YES to all of the above, it is recommended to get an injection called Rh-immunoglobulin (commonly known as brand name RhoGAM).

What is RhoGAM and why is it so important?

(Here’s where it gets a little medical—read on if you're curious, or you can skip to the part how to find out if you're Rh-negative.)

If your blood type is Rh-negative and you're pregnant with a fetus who has an Rh-positive blood type, this is called Rh incompatibility. When this happens, there’s a chance for something called Rh sensitization.

Rh sensitization means that if Rh-positive blood from the fetus mixes with your Rh-negative blood, your body can have an immune reaction by creating antibodies that may attack Rh-positive blood cells and cause harm to a future desired pregnancy.

When someone with Rh-negative blood is exposed to Rh-positive blood, their immune system can become “sensitized.” That means it starts making antibodies against the Rh-positive blood, treating it like an invader and trying to destroy it.

This immune response usually doesn’t cause problems during the first pregnancy because the pregnant person’s blood usually doesn’t mix with the fetus’s blood until delivery, therefore antibodies don’t form until after delivery. But in future pregnancies, if the fetus has Rh-positive blood, those antibodies could attack the fetus’s red blood cells leading to a condition called hemolytic disease of the newborn (HDN) or miscarriage.

During routine prenatal care pregnant people with Rh-negative blood types will receive an injection from their provider called RhoGAM to stop these antibodies from forming. This injection is given around 28 weeks of pregnancy and then again within 72 hours after the delivery to make sure future pregnancies are safe.

For people having an abortion or miscarriage and who plan to have kids in the future, the RhoGAM shot will protect those future pregnancies. New research shows that if you’re under 12 weeks, there's no reason to get RhoGAM before or after taking the pills or having an abortion procedure, since there's no evidence that Rh sensitization can occur this early in pregnancy. After 12 weeks, however, the pregnant person should get a RhoGAM shot within 3 days of taking mifepristone or misoprostol or within 3 days of having an abortion procedure to help avoid Rh sensitization in the future.

How can I find out if I’m Rh negative?

If you’ve given birth before, had a blood transfusion or donated blood you may already know this! Your blood type doesn’t change so it's not something that needs to be done over and over again.

If you don’t already know your Rh status before your appointment, that is ok. For people above 12 weeks pregnant you will be able to have a blood test to find out your Rh status during your appointment. If you would like to know your Rh status before your appointment there are a few options:

• Ask your parents or your doctor, they may already know!
• Next time you get your blood drawn you can ask if they will check your Rh status
• At-home blood test or self-order lab visit
• Blood donation

If you know your Rh status or are planning to bring a copy of your blood work results with you to your abortion appointment, just verify before your appointment that they will accept self-reported results or results from elsewhere.

Do I need to know my blood type before traveling to my appointment?

You only need RhoGAM if you’re Rh-negative and over 12 weeks pregnant. If you would like to try to find out your Rh status before you travel to your appointment you can use one of the options discussed above. If that is not possible when you arrive at your appointment your Rh status will be checked or you may be offered RhoGAM even if you don’t know your blood type as it is generally not dangerous to receive RhoGAM if you are Rh positive. 

Does the doctor need to know my partner’s blood type?

If you are Rh negative and 100% certain your partner is also Rh negative, then the pregnancy’s blood type would also be negative and there’s no need for the RhoGAM injection.

How soon after an abortion or miscarriage should I get a RhoGAM shot?

Within 3 days of taking mifepristone or misoprostol or within 3 days of having an abortion procedure or miscarriage. But, if you aren’t able to get RhoGAM within 3 days of recommended time, talk to a medical provider. Or call or text the Miscarriage and Abortion Hotline at (833) 246-2632

I’m having an abortion or miscarriage at home, how do I get RhoGAM?

If you're under 12 weeks pregnant (that's 11 weeks and 6 days or less to be exact), you do not need it.

If you’re over 12 weeks pregnant some options include calling your obgyn, midwife, primary care provider or going to the ER. You do not need to say that you had an abortion, some people say they had miscarriage and need the RhoGAM shot. Remember it’s recommended to get the shot within 3 days of the abortion or miscarriage.

It’s also not harmful to get a RhoGAM injection if you’re unable to get a blood test or are unsure what your blood type is.

Have questions before, during or after an abortion?
Reach out to the Miscarriage and Abortion Hotline to talk with a volunteer doctor. Call or text (833) 246-2632

Figuring out your abortion options may feel overwhelming, and sometimes you just want to talk to a real human who understands how to navigate it all. While I Need An A has tools, guides, and blogs to help you explore all of your options in any state, we know there are moments when clicking through a website isn’t enough. So, we teamed up with the amazing folks at the Miscarriage + Abortion Hotline to launch something new: now you can chat directly with a trained, nonjudgmental volunteer right on our site.

We're starting small: for now, it's available only in certain states and volunteers are online Monday through Friday, 11 AM–3 PM CT on ineedana.com. More to come soon!

How do I chat?

Use our search feature and scroll down to “What are your biggest questions?”. If chat is available in your state you’ll see it under “I need help. Who can I talk to?”.

What the chat can help with:

While volunteers cannot make abortion appointments directly, they can answer logistical questions like:

• What are my abortion options?
• How can I get help paying for my abortion?
• What are the differences between pill providers?

How it works:

• It’s free to use, and works from your phone or desktop
• Available in Spanish and English
• Volunteers can send you direct links to clinics, funds and other resources
• The chat will delete automatically after one hour of inactivity or if you close the ineedana.com window completely.
• If you get disconnected, just start a new chat!

Big BONUS - Privacy by design:

By chatting directly on ineedana.com, there won’t be a record of your conversation in texts or your call history, further keeping your abortion as private as you want it to be.

Learn more about how we protect your data in our Privacy Guide

Learn more about I Need An A

Again, we’re starting small - this is an experiment! If you have questions that need a person to speak with and our chat isn’t online, we highly recommend:

• M+A Hotline: get medical questions answered
• Repro Legal Helpline: get legal questions answered
• Reprocare: peer support hotline for people using pills
• All-Options: peer support hotline for people who are still exploring all of their pregnancy options.
• Aya Contigo: A spanish-language first abortion digital companion with trained abortion accompaniment

For other resources that can help explain your abortion options, we recommend:

• Chat with Charley: a chatbot that can help you understand your options
• Plan C Pills: an up to date guide specific to how to get pills by mail in all 50 states

As always, if you have feedback, questions, or ideas - don’t hesitate to let us know! team@ineedana.com

Period pills are the same medication as abortion pills—whether that’s using the mifepristone + misoprostol combo or misoprostol on its own. The main difference is not knowing if you’re pregnant or not. Period pills embrace uncertainty.

The medications (we call them mife and miso for short) are so safe that you can take them without taking a pregnancy test. If you are pregnant, the pills will cause an abortion. And if you aren't pregnant, the pills will start your period. When people take them within a week or two of a missed period, they will likely have bleeding similar to their regular period or slightly heavier.

“Period pills” or “menstrual regulation” is a practice used in many countries early in potential pregnancy when someone has missed their period. We think that a shift in language and framing, like using “menstrual regulation” was helpful in countries where abortion has long been banned. In Bangladesh, for example, menstrual regulation is legal and widely available through government supported clinics, even though abortion is illegal (yes! These are still the exact same pills!). In some places, “bringing down a period,” is culturally and legally more accepted than ending a confirmed pregnancy – even if the results are exactly the same: not being pregnant.

Let’s get into the history a little bit..

Before pregnancy tests, most people didn’t know right away if they were pregnant—they relied on a missed period as the first sign, but often didn’t know for sure until the “quickening,” around 14–20 weeks, when fetal movement could be felt. Throughout history and into the U.S. colonial era, if someone’s period was late, midwives would often try different methods to “bring down” a menstrual period. But how we thought about pregnancy started to change in the 1920s, when scientists discovered the pregnancy hormone hCG, which is what tests detect. Then, in the 1970s, at-home pregnancy tests became available, which allowed people to know a lot earlier (learn more about the history of the pregnancy test).

But pregnancy isn’t always black and white—it’s not like one day you’re not pregnant and the next you fully are. Early pregnancy is more of a process, starting with small hormonal changes. This is where period pills come in—they create space for a different way of thinking. Instead of needing to confirm a pregnancy, some people use these medications at the first sign of a missed period, without taking a test. For a long time, doctors required a positive pregnancy test before prescribing mifepristone or misoprostol, but we now know these medications are safe and can be used even earlier.

Now abortion pills have a really cool beginning in our opinion. Misoprostol (also known as Cytotec) was first made in the 1970s by a U.S. pharmaceutical company to treat stomach problems and ulcers. The bottle warned not to use it if you were pregnant, but in Brazil (where abortion was illegal), activists believed it could help women avoid unwanted pregnancies. And it worked! In the late 80’s, misoprostol began to be used widely for abortions across Latin America through activist networks where they shared safe ways to use it.

Misoprostol works by softening and dilating the cervix (the opening to the uterus) and causing the uterus to contract. These contractions are similar—though usually more intense—to cramps during a period. So, when there is a pregnancy in the uterus, misoprostol causes the uterus to expel it (which is exactly how a miscarriage happens, too). When there isn’t a pregnancy, the misoprostol can cause the uterine lining to shed, which triggers a period.

Image by Arwen Donahue, originally shared by We Testify.

Mifepristone (RU-486) on the other hand, was developed in 1980 by French scientists to specifically block the pregnancy hormone progesterone and end early pregnancies. In the late 1980’s and early 1990’s, clinical studies showed that using mifepristone followed by misoprostol was more effective than mifepristone alone. And in the 2000s this protocol was the standard of care globally.

Image by Arwen Donahue, originally shared by We Testify.

Mifepristone and misoprostol have been proven to be safe for people using them and effective for ending pregnancies. Normal side effects of the pills are cramping, bleeding and nausea whether you are pregnant or not and there are no long term health effects to taking these medications.

So now that we have a better understanding of the badass roots and the activists who helped shape abortion care today, why period pills?

Abortion has become more and more regulated in the U.S., and some states have banned doctors from performing them completely. The idea of "period pills" or "menstrual regulation" isn’t widely used here, mostly because abortion is still technically accessible—whether it’s at a clinic in protected states or sent by mail—so, people still have options. In countries like Bangladesh, though, menstrual regulation is legal even though abortion is banned. The U.S. doesn’t have specific laws about menstrual regulation (yet). And while most abortion bans here say the pregnant person can’t be criminally charged, self managing an abortion can still have legal risks. Taking these pills earlier can offer a way for people to avoid having to navigate the laws, logistics, expenses and stress of abortion access, especially in states where it’s banned.

That said, there is growing interest in this approach among people in the U.S. Between 2015 and 2017, the Gynuity Health Project surveyed people to understand why they might be interested in period pills. 70% of the participants who stated they would be unhappy if they found out they were pregnant expressed interest in taking period pills. Their reasons were to prevent and avoid being pregnant, as well as the potential emotional stress of finding out they were pregnant. 

If your period is late, it’s okay to not want to confirm a pregnancy.

There are many providers who will send you pills—no positive pregnancy test required. You can find a list of these providers on The Period Pills Project website.

Most of these providers will allow you to order pills in advance (sometimes referred to as “advanced provision") to make it even easier to take if you miss a period and don’t want to take a pregnancy test.

How to take period pills:

Follow the protocol outlined by the M+A Hotline.

If you follow the instructions and your period is late because you’re pregnant, these pills are 85-99% effective. You can find more information on how to be sure they worked or steps to take if you’re worried they didn’t in our guide on taking abortion pills before 6 weeks.

Here’s our take..

Our bodies are more beautiful and complex than words can perfectly describe or what any law should control. What matters most is that you get to decide if and when you carry a pregnancy and the more tools you have available to help you do that, the better.

And the lines get blurry with the words we use to describe pregnancy prevention. A miscarriage is a spontaneous abortion. An IUD is both preventative birth control and can be used as an emergency contraceptive. Ella is another type of emergency contraceptive pill, and new studies suggest it could be even more effective when used with misoprostol. And then there are abortion pills—which can be used for abortion, menstrual regulation, or even as a kind of emergency contraception if they are taken early enough.

You get to decide what your experience is called and what it means to you. With the safe and trusted options of mifepristone and misoprostol, you also get to choose when it makes the most sense for you—whether that’s after confirming a pregnancy or before, simply at the sign of a missed period. Ineedana.com is here to help you get the care you need—however you frame it, and whatever name you give it 💜

When we’re expansive in how we talk about abortion, we don’t just expand access, we expand safety and dignity for everyone.

A lot of abortion funds and practical support organizations have been distributing emergency contraceptives in their communities for years—just another reason why we love abortion funds so much! Funds distribute emergency contraceptive pills like Plan B or Julie—also known as “EC”—and usually other products like pregnancy tests, condoms and lube by volunteer delivery, pick up location or mailing them.

You can find free plan b in your community by going to www.ineedplanb.com

What is Plan B?

Emergency contraceptives like the “morning after pill” or the name brand Plan B, is a pill that’s taken after unprotected sex that slows down ovulation, which can help stop a pregnancy. Its active ingredient is the synthetic hormone levonorgestrel that delays ovulation or delays the egg from being released from the ovary.

Levonorgestrel tablets (or Plan B, Julie, My Choice, and many other generic brands) are most effective within 72 hours after sex without a condom or birth control or if the condom breaks. But, the sooner you take it the better!

Can I take Plan B to terminate a pregnancy?

Plan B or other emergency contraceptive tablets that have levonorgestrel are not abortion pills. If you need an abortion and want to take medications, you’ll need mifepristone and misoprostol or just misoprostol. You can learn more about the medication abortion process here. And if you need an abortion, go to ineedana.com to find the best option for you based on your location!

How can I get Ella?

Ella is another type of emergency contraceptive, or morning-after pill, but you must have a prescription from a nurse or doctor. It can be taken up to 5 days after unprotected sex and is as effective on day 5 as it is on day 1.

People have questions about their legal rights to abortion. It can be confusing because abortion laws and immigration laws are changing a lot. That’s why I Need An A and the lawyers at If/When/How wrote this guide.

Please know:

• You do not have to tell anyone your immigration status to get an abortion.
  
• But how you have an abortion, and where you have an abortion, could matter. If you have an immigration lawyer, talk with them. Ask them what could put you at legal risk if you get an abortion. If you don’t have an immigration lawyer, or aren’t sure if you need one, the Repro Legal Helpline may be able to help. Call (844) 868-2812.
  
• We want everyone to feel safe. If you are worried about your privacy, read our privacy guide.
  
• If you’re an immigration lawyer and have questions about abortion laws or want to learn more about how to support abortion seekers, contact If/When/How.

Where can I get an abortion?

Abortion laws are different in every state. But in general, people:

• Travel to an abortion clinic
• Take abortion pills at home

Everyone has the right to travel for an abortion. Use Ineedana.com to find the closest clinics and travel support.

Some people choose pills by mail. Sometimes they choose this because abortion is banned where they live. Or because they can’t travel. And sometimes they just prefer doing it at home. This is called self-managed abortion (SMA).

SMA means ending a pregnancy on your own, without the support of a doctor. Many people self-manage. It is common. It is medically very safe. And SMA is not a crime in any state (except after 24 weeks of pregnancy in Nevada).

But sometimes, people who self-manage abortion are investigated or even charged by the police, child protective services, or immigration. That is because what the laws say and what happens in reality can be different.

To get legal advice about your rights and possible risk, contact the Repro Legal Helpline at 844-868-2812.

Can I travel to get an abortion?

Yes. Everyone has the constitutional right to travel. But if you are not a citizen, there could be legal risk. There is a chance you get stopped by local police, ICE, or Customs and Border Patrol (CBP) while traveling. You know your needs better than anyone.

If traveling is right for you, learn more about:

• Deciding to travel for an abortion
• Finding support organizations that can help you coordinate and pay for travel
• Abortion for people under age 18

If you don’t want to or can’t travel, some people self-manage at home. But there could be legal risk with this too. Here’s more information about self-managing

• Different ways to get pills
• Pills by mail after 12 weeks pregnant
• Self-managed abortion
• Privacy and digital safety

If I decide to travel, what should I consider?

If you are not a U.S. citizen, it might feel scary to travel, especially across state lines, right now. Here is more information on traveling when undocumented. And here are some questions to think about:

Will the clinic make me show ID?

Clinics will ask for a photo ID. You can use a driver’s license, passport, or school ID. If you do not have a photo ID, ask the clinic what you can do.

Will the clinic or abortion fund ask about my immigration status?

No. Clinics should not ask about immigration status. But if they do, you do not have to answer. And the clinic cannot turn you away for not answering.

If you are worried, you can call the clinic to ask about their policies on ICE.

Questions you can ask the clinic:

• Do you allow ICE into the building?
• Has ICE ever been to the clinic?
• If ICE shows up, what does the clinic do?

You can ask other questions about your safety too. For example, you can ask how the clinic handles protestors. Or you can ask about their rules for calling the police.

Local abortion funds may also have information about ICE. Abortion funds will never ask about your immigration status. And some, like Frontera Fund in Texas, have special support for people who are undocumented.

What if I need to go to the hospital? Can they refuse to treat me because of my immigration status?

No. Hospitals cannot turn you away because of your immigration status. They cannot share your information unless you say it’s okay or if there is a warrant by a judge. Click here to learn more about what a warrant from a judge.

In 2024, Florida and Texas made a rule that hospitals have to ask about immigration status. The states said it is for statistics. But you do not have to answer. And no matter what you say, the hospital still has to treat you.

Learn more about what to do if you need to go to the emergency room during or after an abortion.

If you’re a clinic or abortion provider and want to learn more about how to protect your patients, check out this Know Your Rights guide by the National Immigration Law Center.

How can I protect myself if I travel out of state for an abortion?

No matter how you decide to travel:

Traveling by land:

If you’re taking a Greyhound bus, you do not need ID. Also, Greyhound says it does not allow ICE on its buses or bus stations.

If you’re taking the Amtrak train, you do not need ID to buy a ticket. Amtrak may do random ticket checks on trains.

Traveling by plane:

You can fly in the U.S. (including all 50 states and U.S. territories) with a foreign passport.

If you’re traveling to or from Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, or the Northern Mariana Islands, CBP may do extra inspections. Talk to an immigration lawyer before traveling to any U.S. territories.

How can I keep people in my community safe?

Keeping your community safe means knowing where and how to get an abortion. Sharing trusted resources has never been more important—everyone has the legal right to share information about abortion, no matter where they live.

If you work at an abortion fund or clinic, make sure your written materials are translated into the most commonly spoken languages in your community, and have interpreters available either in-person or over the phone.

If you’re a healthcare provider, remember that you are not required to give or facilitate police access to any of your patients, especially if it would put your patient’s condition at risk.

You should always:

• Ask to see a warrant
• Tell your patient they have the right to remain silent and talk to a lawyer first
• Stay with your patient if police insist on questioning them

You can help by sharing this article and...

It’s not uncommon to throw up when taking abortion pills (and definitely not pleasant). Nausea and vomiting are pregnancy symptoms after all.. but we hear a lot of people worry that the pills won’t work if they puke, so we talked with doctors and doulas to answer your questions on when not to stress, when to consider taking more, and how to avoid puking in the first place.

What if I throw up after taking mifepristone?

We know that as long as mifepristone stays in your body for 60 minutes you get most of the medication and do not need another tablet. But if you throw up before 60 minutes or see the pill when you vomit, you’ll need to take more Mifepristone or you can switch to the misoprostol only protocol (which requires more misoprostol). Keep in mind, it may take time to request more mifepristone from the provider.

Note: Mifepristone by itself will not be enough to have an abortion—it must be taken with misoprostol. But, people still successfully and safely have an abortion with only misoprostol, it just requires more of the tablets.

Review how to take abortion pills here.

What if I throw up after taking misoprostol?

As long as the misoprostol has been sitting in your cheek for 20 minutes, it will work. Some people know they’re about to throw up, so they take the tablets out, throw up, and then put them back in. It’s harder to do than it sounds, but it's something to keep in mind. If you throw up before 20 minutes you might need to take more misoprostol. If the misoprostol is thrown up 20 minutes after it has been in the mouth or after it is swallowed it is working and that dose does not need to be repeated.

How can I avoid throwing up while taking the misoprostol?

Let’s start by explaining how misoprostol is taken. It is not swallowed immediately, instead it’s taken buccally which means the tablets are placed in between the cheek and the gum to dissolve. Not only is this way more effective for the abortion but it also makes taking the misoprostol easier on your stomach. Some of the side effects of the medication are nausea and vomiting. So by taking the misoprostol in between the cheek and the gum allows it to be absorbed into the bloodstream instead of through the stomach lining. You’ll likely still feel nauseous though.

When prescribed misoprostol, many health care professionals will also prescribe ondansetron (Zofran) which is an anti-nausea medication. If that isn’t offered to you, you can always ask! Or you can pick up dimenhydrinate (Dramamine) or diphenhydramine (Benadryl) at your pharmacy—no prescription needed. It’s helpful to pre-treat the symptoms of the misoprostol so you’re not playing catch up with the symptoms of the medication. In other words, misoprostol causes cramping and nausea so you want to take the pain relievers and anti-nausea medication before taking the misoprostol. And then continue to take as directed.

Step 1: Eat something light

Step 2: Take a pain reliever
This can be 800mg of ibuprofen (Motrin/Advil) and/or 1000mg of acetaminophen (Tylenol). If you are prescribed stronger pain relievers by the doctor, follow those directions.

Step 3: Wait 30 minutes

Step 4: Take the anti-nausea medication

Step 5: Wait 30 minutes

Step 6: Place the misoprostol tablets in between the cheek and the gum.

Abortion pills can be taken on an empty stomach and anti-nausea medications can be taken before or after the Mifepristone or misoprostol. The suggested steps above may not make the nausea or vomiting go away completely but it may help! Make sure to follow the directions of the pain relievers and anti-nausea medication and take as needed.

What are other ways to prevent or treat nausea and vomiting after taking abortion pills?

• Drinking ginger tea or chewing on ginger candies
• Other teas that can help with nausea: peppermint, chamomile and lavender
• Smoking weed can prevent nausea
• If you’re usually nauseous and throwing up in the morning from the pregnancy, try taking the Mifepristone in the evening instead.
• Sniffing an alcohol wipe or peppermint oil
• Placing an ice pack to the back of the neck

Abortion medications are extremely effective in ending a pregnancy when following the correct protocol, and many people do this successfully every day. If you had bleeding and passed any clots, it’s very likely the abortion was successful. But, let’s dive in deeper into what to expect and the timeline so you feel confident and prepared!

Pregnancy symptoms like nausea, breast tenderness, tiredness or fatigue should go away.

Pregnancy symptoms disappearing are a good way to tell that the pills worked. Nausea and fatigue should go away within a few days, and breast tenderness can take longer, maybe up 1-2 weeks. Not “feeling pregnant” anymore is a sign that the abortion was successful.

You see the pregnancy in your pad or in the toilet.

Less than 8 weeks since the last menstrual period:

Some people report seeing white tissue of the pregnancy sac, but most people don’t see anything because it is so tiny. Passing any clots is a good sign!

Between 8 and 10 weeks:

People may be able to spot the pregnancy or sac (though it’s still less than an inch long) if they choose to look.

After 10 weeks:

The pregnancy or sac will look different from other clots.

It’s also ok to not look for a pregnancy/sac or inspect the pad or toilet. The experience can look and feel different.

Go to this article for information about pills after 12 weeks.

You can take a urine pregnancy test 4 weeks after the abortion.

Pregnancy tests have gotten really great at detecting HCG (the pregnancy hormone) earlier, which can be frustrating when you are no longer pregnant but the test is still detecting the small amount of hormones still in your body. It’s possible to test positive on a pregnancy test up to 6 weeks after a successful abortion.

We encourage everyone to take a home pregnancy test 4-6 weeks after taking the abortion pills.

Trust your body.

We know it can be hard, but you really can trust your body! We’ve been made to feel like we can’t trust our bodies and can only rely on a medical professional to confirm.

It’s also normal to want confirmation! Want to ask a doctor or nurse?
Call the M+A Hotline at (833) 246-2632

What are other ways to make sure the pills worked?

You could get an ultrasound. Waiting 1-2 weeks can give the uterus time to empty and avoid an unnecessary procedure.

You could also get two quantitative beta hCG tests (blood tests) at least 48 hours apart, and if the hCG levels go down between the two tests that means you are no longer pregnant.

And Ineedana.com has built a database of trusted providers in heavily restricted states where you can get ultrasounds, pregnancy tests, post abortion care and miscarriage management.

Note: Be aware of fake clinics or crisis pregnancy centers (CPC’s) that advertise free ultrasounds in your community.

Other common questions

I’m worried about an “incomplete” abortion.

The support team at Reprocare hear this concern a lot– it is normal to continue passing blood and tissue in the days and weeks after a successful abortion. An incomplete abortion is when too much blood and tissue remains in the uterus days to weeks after taking the misoprostol, and it has noticeable symptoms.

These symptoms include heavy bleeding for hours that doesn’t slow down, fever above 100.4, and/or severe pelvic pain that can’t be relieved by painkillers like ibuprofen more than 2 days after the abortion process. This is rare, but someone experiencing these symptoms should seek medical care.

I’m actually pretty sure the pills didn’t work, what do I do?

There is a small possibility the abortion pills didn’t work at all. If someone did not bleed or pass clots, or had only light spotting, another dose of misoprostol can be taken.

If the abortion was unsuccessful, you can try again by repeating the abortion medication protocol or get an in-clinic procedure.

What if I’m over 12 weeks pregnant?

For people who are over 12 weeks and using abortion pills, we have an article about what to expect. Someone at this stage will know the process was successful because they passed a fetus and the placenta.

What are normal symptoms during an abortion?

• Heavy bleeding
• Passing small or large clots or some gray or white tissue
• Cramps or abdominal pain
• Back pressure or pain
• Nausea and/or vomiting
• Diarrhea

How long will I bleed for?

Usually after taking the misoprostol, people have the heaviest bleeding and passing of clots and pass the pregnancy within 12-24 hours.

It’s normal to continue bleeding or passing clots in the days and weeks after, sometimes bleeding continues up to the next menstrual period (4-6 weeks later).

As long as the following complications aren’t happening, you’re ok.

Potential complications more than 24 hours after taking the pills:

• Having very heavy bleeding and soaking through more than 2 overnight maxi pads per hour for 2 hours in a row
• Severe pain that isn't better with over the counter pain medications (like tylenol or ibuprofen).
• Running a fever of 101°F or greater and/or a really foul smelling discharge. These (in addition to pain) are signs of infection and should be treated immediately.

Learn what to expect if you go to the ER after an abortion or miscarriage.

It’s normal to feel stressed about this but these resources are here to support you! You aren’t alone <3

Many people take abortion pills when they are very early in their pregnancy, or less than 6 weeks pregnant. This experience might look different than one might expect!

You may read stories online about other people having very heavy bleeding, passing large clots, and having a lot of pain during their abortion. And if your experience doesn’t match that, it’s normal to be concerned it didn’t work

In reality, there is a wide range of normal experiences after taking abortion pills. Some people have heavier bleeding and some people have lighter bleeding. Every abortion experience is different.

We want you to understand the range of possible experiences so you can feel confident assessing if your abortion was successful!

What should I know about taking the pills before 6 weeks?

Abortion pills are very effective early in pregnancy.

Even early in pregnancy, abortion pills are still very effective in ending pregnancy. Some people may choose to wait until 6 weeks to take the pills based on some indications that the pills may be slightly more effective after that point. Some people may choose to take the pills earlier and not wait. Since both options are medically safe and effective, it’s up to you when to take the pills.

There are two medication abortion methods: the mifepristone + misoprostol regimen and the misoprostol-only method - both are medically safe and effective. You can check out the M+A Hotline’s protocol for both here.

You may not bleed as much as you expected to.

Before 6 weeks, the pregnancy is quite small. The gestational sac is smaller than a piece of Skittles candy. Because there can be less tissue in the uterus, there can be less bleeding, fewer clots, smaller clots, or no clots. It’s possible to only have ½ a pad-2 pads worth of blood and/or pass 1 single clot for the entire process and still have a successful abortion.

How do I know if it worked?

If your pregnancy symptoms go away within 1-2 weeks of taking the pills, this is a good sign that the pills worked. Fore more info on how to know they worked, check out this article.

If you’re unsure or have questions, you can always reach out to your provider or a provider at the M+A Hotline to talk through your options! Call or text 833-246-2632.

Rarely, having little or no bleeding after taking abortion pills can be a sign of ectopic pregnancy

An ectopic pregnancy (outside of the uterus) happens in less than 2% of all pregnancies. If it ruptures, it can be life-threatening. Abortion pills do not work to end ectopic pregnancies, but they do not cause an ectopic pregnancy to rupture.

If you think you’re pregnant and have extreme pelvic pain (especially on one side), bruising or swelling in the belly, dizziness, lightheadedness, or shoulder pain, these are signs of potential ruptured ectopic pregnancy, and you should go to the ER right away. If you go to get checked out, you never have to tell anyone that you took abortion pills.

We’ve tried to provide an overview of what to expect, but really your experience may vary. That’s why it can be helpful to read other people’s personal experiences. To help, here are some stories from people who got abortions before 6 weeks -

What It’s Like To Have An Abortion At Home

What a Medical Abortion Actually Feels Like

Demystifying Medication Abortion (video)

r/abortion: Medication abortion at 6 weeks, it was okay

r/ Abortion experience at 6 weeks

r/ My Medical Abortion Experience (4 week pregnant)

For more abortion stories, tagged by type of abortions, locations, demographics, feelings and more - check out ineedana.com/stories.

Most people do not need emergency care after an abortion or miscarriage. Research shows that abortion is safe and complications happen in less than 1% of cases. And most miscarriages happen on their own without needing any medical support. Abortions and miscarriages are also the same process, so the medical treatment for both is the same. In fact, the medical term for a miscarriage is “spontaneous abortion” and usually refers to a loss before 20 weeks of pregnancy. You can read more about the similarities of medication abortion and miscarriage here.

You may be worried about getting into legal trouble for a pregnancy loss or worried if you’ll be able to get the medical care that you need. You aren’t alone! There is a lot of misinformation and fear around abortion care, especially depending on where you live. That’s why the Repro Legal Helpline and Ineedana.com teamed up to make sure that if you go to the ER after an abortion or a miscarriage, you will feel prepared.

Here’s what we want you to know:

• You have the legal right to get emergency medical care in an emergency room in every state, even if your state bans abortion. Emergency medical care includes treatment for a pregnant person in labor or having a miscarriage. You have this legal right no matter your age, immigration status, or whether you have insurance.
• You do not have to tell anyone about your abortion.
• You can bring someone you trust with you to the hospital so you don’t have to stand up for yourself alone. But keep in mind that hospitals can have different visitor policies.
• If you're bleeding a lot, you can say things like "I'm pregnant, I started bleeding and I'm very worried. I would like blood work and an ultrasound to figure out what's going on."
• You do not have to tell anyone what you want to do with a pregnancy, or if you change your mind about what you want to do.
• You have the legal right to travel between states for any reason and no matter your age, unless you’re under a court order like probation or parole. You don’t have to tell anyone why you’re traveling. No state makes it a crime for pregnant people to travel to another state for an abortion, but there can be reasons why traveling between states has legal risks. For example, your legal risk can depend on your immigration status. Call the Repro Legal Helpline at (844) 868-2812 if you’re not sure if you can travel.
  

How do I know if I need to go to the hospital?

• If you have very heavy bleeding and soak through more than 2 overnight maxi pads per hour for 2 hours in a row
• Running a fever of 101°F or greater
• A really foul smelling discharge with severe pain that isn't better with over the counter pain medications (like tylenol or ibuprofen), and fever are signs of an infection that should be treated immediately.

You can also call the Miscarriage + Abortion Hotline at (833) 246-2632 to discuss your symptoms—they can help you understand if you need medical attention. Check out this article for more information on what to expect when having a miscarriage.

What to expect at the hospital

You only have to share what you feel comfortable telling hospital staff. A healthcare provider only needs to know that you were pregnant, how far along you were (if you know), and what symptoms (e.g., bleeding, cramping, fever, etc.) you have. If you are more than 12 weeks pregnant, read more here. There is no law that says you have to tell anyone about having an abortion.

Unless you tell them, hospital staff probably will not know whether you had a medication abortion or a miscarriage.

Healthcare providers can't tell the difference between a medication abortion and a miscarriage by examining or testing you—the symptoms for both are the same. And if you need medical care after either, doctors will usually treat them in the same way.

When misoprostol is dissolved under the tongue or between the cheek and gum, and any leftover pieces are swallowed or spit out, doctors won’t be able to see the pills. But if misoprostol is placed in the vagina, a doctor might notice any leftover pill during an exam. That’s why many people prefer to take the pills by mouth.

You can read more about how to talk to a healthcare provider here.

What do I do if I go to a hospital and they refuse to help me?

Call Repro Legal Helpline at (844) 868-2812 or contact us through our secure online form to speak with a lawyer. Tell us that you’re being denied emergency medical care and we’ll get back to you immediately.

We encourage you to bring a friend or family member with you to the hospital, because you may be in a situation where you need to advocate for yourself. It’s hard to do that alone if you’re scared or in pain.

You, or your trusted person, should write down (on paper or in a Notes app on your phone) everything that happens, including:

• The name of the hospital
• Any treatment you are offered and/or receive
• What the hospital staff says to you and any reasons they give about why they will not treat you
• The names of the nurses, doctors, or other staff you talk to
• The date and time you arrived and left the hospital

We recommend you write or use your Notes app instead of recording at the emergency room, because some states do not allow people to record others without their permission.

If you feel comfortable, you can:

• Ask why you are being denied care and that they put their reason in your medical chart
• Tell them: “I have the right to stabilizing medical care under the Emergency Medical Treatment and Labor Act (EMTALA).”
• Ask the hospital to transfer or transport you to another hospital that will provide you care that you need
• Ask how to request your medical records, including a copy of labs and imaging, and to sign up for the online patient portal, like MyChart, if you haven’t already

Make sure to write down in your notes that you asked these questions and their answers.

If you forget to take notes, or can’t, that’s okay. When the emergency is over, you can write down everything you remember, or call the Repro Legal Helpline (844) 868-2812 and tell us what you remember. The Repro Legal Helpline is free and confidential.

What do I do if the hospital calls the police?

Do not talk to the cops

Tell the police that you will not talk to them without a lawyer present. It is always better for you, no matter what, to talk to a lawyer before you answer questions from a police officer. You have the right to remain silent, or to have a lawyer with you if you do answer any questions. After you refuse to talk to the police without a lawyer, call or have a loved one call the Repro Legal Helpline at (844) 868-2812 immediately. Be sure to tell Repro Legal Helpline that you’ve been contacted by the police and include a phone number where you can be reached.

You may need to be careful about talking to anyone at the hospital

Hospitals are not supposed to share your private medical information with the police. But, sometimes doctors, nurses, or other hospital staff may do that anyway, and people who work with cops, like a social worker or child protective services worker, might try to question you too. Any of those people might tell the police what you say. You don’t have to talk to them. You can always say, “I’m not comfortable answering your questions and I want to talk to a lawyer first.” then contact the Repro Legal Helpline.

Learn more about your rights when contacted by police, immigration, or CPS here.

Are some emergency rooms better than others?

Not everyone has a choice of more than one hospital. You might live near only one hospital with an emergency room. Or you might have insurance that pays for only certain medical centers. Even if you have only one option, that emergency room has to take care of you in a medical emergency.

If you have more than one hospital option and want to be prepared in case you ever need to go to the hospital, it can be helpful to do some research ahead of time. You can call hospitals or doctor’s offices and try asking:

"Hi, I’m calling to get some information about miscarriage management at your hospital. Can you connect me with someone who can answer questions about hospital policies and available treatment options?"

• (You may need to ask for Labor & Delivery, the Emergency Department, or a patient advocate.)

"Can you tell me about your hospital’s miscarriage management guidelines?"

• (If they seem unsure, you can clarify: “I’m specifically asking about how early pregnancy loss is treated and whether there are standard protocols in place.”)

"When a patient is experiencing a miscarriage, are doctors expected to go over all three management options—watch and wait, medication, and a procedure?"

• (Follow-up: “Will the doctor allow the patient to choose their preferred treatment, or are there restrictions on certain options?”)

"Does your hospital have doctors who are trained in D&E (dilation and evacuation) procedures? Are any of them fellowship-trained in Complex Family Planning?"

• (If they don’t know, ask: “Is there someone in OB/GYN I can speak to who might know?”)

"If a patient needs a higher level of care or a procedure your hospital doesn’t provide, what is the process for transferring them to another facility?"

• (Follow-up: “Does the hospital have any policies that could delay or prevent a transfer?”)

"Is your hospital Catholic-affiliated or connected to a religious system that restricts miscarriage or abortion care?"

• (If they seem unsure: “Do your hospital policies allow for miscarriage management even if there is still a fetal heartbeat?”)

Keep in mind:

• It may be hard to get someone on the phone or even have these questions answered by hospital staff. You can try connecting with a local pregnancy/birth doula who may have a better idea on hospital policies and people’s experiences too.
• In some communities the only available hospital or healthcare providers available are religiously affiliated (i.e., most likely anything with “St.” in the name)
• Some people live in very small towns where everyone knows everyone and it’s hard to keep things private.

And remember, you know your community and where you live best and how providers may react.

If you’re not experiencing a medical emergency and just want to get checked out after a miscarriage or abortion, you do not have to go to the emergency room. You’re already in the right place to find trusted medical providers who offer abortions.