How to have an abortion with pills if mife isn’t available

Abortion pills, often called medication abortion, are a safe and effective way to end a pregnancy. In fact, abortion pills now account for more than half of all abortions in the U.S.

A misoprostol-only abortion uses misoprostol by itself to safely end a pregnancy when mifepristone isn’t available.

There are two ways (also called “regimens”) to have an abortion with pills:

• A combination of mifepristone and misoprostol (often called mife and miso)
• Misoprostol on its own (sometimes called miso-only)

What is the step-by-step process for a safe misoprostol-only abortion (up to 12 weeks)?

This guide covers misoprostol-only abortions up to 12 weeks of pregnancy. Learn more about abortion pills after 12 weeks.

Step one:
Optional, but highly recommended: take 800 mg of ibuprofen (or another pain reliever if you’re allergic to ibuprofen). This helps with cramping. Wait about one hour for it to start working.

Step two:
Put four 200-microgram (mcg) misoprostol pills between your cheeks and gums or under your tongue. Hold them there for 30 minutes. Don’t talk or eat while they dissolve.

After 30 minutes, drink water and swallow what remains — it’s totally okay if the pills don’t fully dissolve.

Step three:
Wait 3 hours. (Your timer can start when you first place the pills in your mouth — the 30 minutes counts.)

Step four:
After 3 hours, repeat steps 2–3 with four more 200 mcg misoprostol pills.

Step five:
After another 3 hours, repeat steps 2–3 again with the final four 200 mcg misoprostol pills.

Make sure you take all 12 pills even if you start to bleed before you’ve taken all of them.

If your provider gave you a different misoprostol schedule or dosage, that can still be safe and effective. You can read more about why regimens may vary here.

What should you expect after taking misoprostol?

Most people experience cramping and bleeding, often heavier than a period. Bleeding and cramps are expected and usually mean the medication is working.

You may also experience nausea, dizziness, vomiting, diarrhea, headache, and fever and chills. All of that is normal and not cause for concern.

Be sure to think about self care: stay hydrated, eat a meal, use a heating pad or hot compress, and have pain meds ready. Do everything that makes you comfortable during a period. It’s often helpful to have a support person with you.

For more information, check out this longer, more detailed video.

If you’re having an abortion at home and worried you may be experiencing complications, you can contact the Miscarriage + Abortion Hotline at 1-833-246-2632.

How do you know if your abortion was successful?

For most people, the abortion will be complete within 24 hours.

It’s normal to continue testing positive on an at-home pregnancy test for several weeks. For the most accurate result, wait at least 4 weeks before taking a pregnancy test. Some people may test positive for 4–6 weeks even after a successful abortion.

Additional doses of misoprostol can be used if needed to ensure the abortion is complete. More protocol information can be found from medical organizations like ACOG and RHAP.One thing to note: abortion accompaniment groups and community providers often recommend waiting until you’re at least 5 weeks pregnant before using misoprostol alone, since it tends to work better after that point.

For a more detailed breakdown of signs, timelines, and common questions, read our full guide on how to know if the abortion pills worked.

Do you need follow-up care?

Most people do not need in-person follow-up care unless pregnancy symptoms continue or something feels off.

Sometimes people want reassurance, answers to questions, or medical support — which is absolutely ok and should be supported! If you want in-person follow-up care, I Need An A has a vetted database of providers offering miscarriage and follow-up care in restricted states. Learn more here.

Avoid places offering “free ultrasounds” — these are often anti-abortion crisis pregnancy centers, aka fake clinics, which typically do not provide comprehensive abortion care.

Looking for more FAQs?

For more information on the abortion pill and ordering online, check out Plan C's website.

If you'd like peer support throughout the process of planning or having an abortion with pills at home, check out Reprocare's peer-based hotline which is open 7 days a week at 833-226-7821.