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.

Anpil moun gen kesyon sou dwa yo genyen konsènen avòtman. Ap toujou gen yon ti konfizyon sou sijè sa yo paske se tout tan lwa ki dirije avòtman ak imigrasyon ap chanje. Se poutèt sa òganizasyon ki rele I Need An A a ak Avoka If/When/How yo te konpoze gid sa a.

Tanpri sonje:

• Ou pa oblije devwale estati legal ou pou w jwenn yon avòtman.
• Men fason ou resevwa yon avòtman, ak kote ou fè l la ka vin ak konsekans. Si w gen pwòp avoka imigrasyon w, pale avè yo. Mande yo kijan yon avòtman ka mennen risk legal ba ou. Si w pa gen avoka imigrasyon, oubyen si w pa konnen pou ki sa w ka bezwen youn, gen yon liy ki rele Repro Legal Helpline ki ka ede w. Rele (844) 868-2812.
• Sekirite tout moun enpòtan pou nou. Si w bezwen plis asirans pou konfidansyalite w, li gid konfidansyalite nou an. 
• Pou avoka imigrasyon ki gen kesyon sou lwa avòtman oubyen ki ta renmen aprann fason yo ka sipòte moun k ap chache sèvis avòtman, kontakte If/When/How.

Ki kote m ka fè yon avòtman?

Chak eta nan etazini gen lwa pa yo sou avòtman. Men an jeneral, moun:

• Vizite yon klinik avòtman
• Pran konprime pou avòtman lakay yo

Tout moun gen dwa pou yo vwayaje al fè yon avòtman. Itilize Ineedana.com pou w wè klinik ki pre w yo oubyen jwenn èd a transpòtasyon.

Gen moun ki chwazi resevwa konprime yo pa lapòs. Pafwa yo chwazi opsyon sa a paske avòtman ilegal kote yo viv la. Gen lòt fwa se paske yo pa kapab vwayaje. Li toujou posib tou se paske yo prefere fè l lakay yo. Sa rele “Self-managed Abortion (SMA)/(Avòtman Lakay)”.

SMA vle di fè avòtman lakay poukont ou san èd yon doktè. Anpil moun fè chwa sa a. Li popilè anpil. Li pa souvan pote konplikasyon medikal. Epi SMA se pa yon krim nan okenn eta (sof Nevada kote avòtman lakay ilegal apre 24 semèn gwosès).

Men pafwa, yon moun ki fè SMA ka vin sijè envestigasyon oubyen menm gade wè lapolis, depatman pwoteksyon timoun, oubyen imigrasyon akize yo. Sa ka rive paske sa lalwa di ak sa ki pase nan reyalite ka diferan.

Pou w jwenn konsèy legal sou dwa w ak ki danje ki genyen nan domèn sa a, kontakte Repro Legal Helpline nan 844-868-2812.

Èske m ka vwayaje al fè yon avòtman?

Wi. Manman lwa peyi a bay tout moun dwa pou yo vwayaje. Men si ou pa sitwayen, ka gen danje pou ou nan vwayaje fè avòtman. Ap toujou gen yon chans lapolis, ajan ICE yo, oubyen polis fwontyè ak dwàn yo kanpe w nan wout. Sonje se ou menm ki pou deside ki chwa ki fè plis sans pou ou.

Si vwayaje fè avòtman fè sans pou ou, men sa w bezwen konnen:

• Lè w ap pran desizyon vwayaje pou yon avòtman
• Chache jwenn òganizasyon ki ka ede w kowòdine epi peye transpòtasyon pou ou.
• Avòtman pou moun ki poko gen 18 lane

Si w pa vle oubyen si ou pa kapab vwayaje, konnen gen moun ki chwazi opsyon SMA a pou yo ka fè l lakay yo. Men ka gen risk legal nan sa tou.

Men plis enfòmasyon sou SMA:

• Divès fason ou ka jwenn konprime
• Resevwa konprime nan lapòs apre 12 semèn gwosès
• Avòtman lakay
• Vi prive ak sekirite dijital

Ki sa mwen ta dwe konsidere si m deside vwayaje?

Si w pa yon sitwayen ameriken, ou ka pè vwayaje, janbe fwontyè eta, nan moman sa a. Men kèk enfòmasyon pou moun k ap vwayaje san dokimantasyon. Epi men kesyon pou w konsidere:

Èske y ap mande m prezante kat idantite m nan klinik lan?

Klinik yo ap mande pou kat idantite ki gen foto. Ou ka itilize lisans chofè, paspò, oubyen kat idantite lekòl. Si ou pa gen yon kat idantite ki gen foto, mande si yo ofri lòt opsyon nan klinik lan.

Èske klinik lan oubyen fon avòtman an ap poze m kesyon sou estati legal mwen?

Non. Klinik yo pa dwe poze kesyon sou estati legal. Men si yo ta poze w kesyon, ou pa gen okenn obligasyon pou w reponn. Yon klinik pa ka pa ba w sèvis paske ou pa reponn yon kesyon sou estati legal ou.

Si sa enkyete w, ou ka rele klinik yo mande pwosesis yo genyen pou ICE.

Kesyon ou ka poze nan klinik yo:

• Èske nou kite ajan ICE yo antre nan ofis lan?
• Èske ajan ICE yo janm antre nan ofis lan?
• Si ajan ICE yo ta parèt, kijan nou t ap jere sa?

Ou ka poze lòt kesyon pou sekirite w tou. Pa egzanp, ou ka mande kijan klinik la jere manifestasyon. Oubyen ak ki règ yo sèvi lè yo bezwen rele lapolis.

Fon pou avòtman ki pre w yo ka gen enfòmasyon sou ICE tou. Fon pou avòtman yo p ap janm poze kesyon sou estati legal ou. Epi genyen tou, tankou Frontera Fund nan eta Texas, ki gen opòtinite espesyal pou moun ki pa dokimante.

E si m vin bezwen al lopital? Èske yo ka refize trete m akoz estati legal mwen?

Non. Yo pa ka refize trete w nan lopital poutèt estati legal ou kòm imigran. Yo pa ka pataje enfòmasyon w si ou pa dakò oubyen yo pa gen manda yon jij. Klike isit la pou w aprann plis enfo sou manda jij yo.

Nan lane 2024, Florida ak Texas te kreye yon règ pou fòse lopital poze kesyon sou estati legal yon imigran. Yo te fè sa sou pretèks etid estatistik. Men li pa obligatwa pou w reponn. Epi kèlkelanswa repons ou ta bay, fò lopital la trete w kanmenm.

Aprann ki sa pou w fè si ou ta bezwen al nan ijans pandan oubyen apre yon avòtman.

Pou klinik yo ak lòt etablisman ki bay sèvis avòtman ki ta renmen konnen kijan pou yo pwoteje pasyan, tcheke gid National Immigration Law Center te kreye a ki rele Konn Dwa W.

Kijan mwen ka pwoteje tèt mwen si mwen ale nan yon lòt eta pou m fè yon avòtman?

Nenpòt fason ou deside vwayaje:

Si w ap vwayaje pa tè:

Si w ap vwayaje nan bis Greyhound yo, ou pa bezwen kat idantite. Epi tou, Greyhound deklare yo pa kite ajan ICE antre ni anndan bis yo ni nan estasyon bis yo.

Si se tren Amtrak ou pran, ou pa bezwen kat idantite pou w achte yon tikè. Lè w fin montre tren an, Amtrak ka tcheke tikè w achte a le w montre an sanzatann.

Si w ap vwayaje pa avyon:

Ou ka vwayaje nan peyi a (nan tout 50 eta yo ak teritwa ameriken yo) ak paspò etranje.

Si w ap vwayaje ale oubyen soti Pòtoriko, Gwam, Il Vyèj Ameriken yo, Samoa Ameriken, oubyen Il Maryàn Nò yo, Ladwàn ka fè enspeksyon pa l. Konsilte yon avoka imigrasyon avan w vwayaje al nenpòt teritwa ameriken.

Kijan m ka asire sekirite kominote m?

Pou asire sekirite kominote w, fò w konn ki kote ak kijan yon moun ka jwenn sèvis avòtman. Nan moman sa a, pataje resous fyab enpòtan anpil – tout moun gen dwa pou yo pataje enfòmasyon sou avòtman, nenpòt kote yo viv.

Si ou travay nan yon klinik oubyen yon fon ki bay sèvis avòtman, fò ou asire materyèl ekri yo tradui nan lang ki plis reprezante yo nan kominote w lan, epi met entèpretè disponib pou ede fasafas oubyen sou telefòn.

Si w se yon founisè swen sante, sonje ou pa gen obligasyon pou w kite polis gen kontak avèk pasyan w yo, espesyèlman si se pa èd yo vin bay.

Ou toujou dwe:

• Mande si yo gen yon manda
• Fè pasyan yo konnen yo gen dwa gade silans yo oubyen mande pale avèk yon avoka avan yo pale a polis.
• Si lapolis ta ensiste kesyone yon pasyan, pa kite pasyan an poukont li

Pataje atik sa a pou w ede nou…

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.

This is a guide for sex workers from sex workers on how to navigate abortion. We teamed up with the baddies at SWOPLA who run the Sex Workers’ Abortion Navigation Services (SWANS) to create this guide that offers a supportive, sex worker–informed perspective on accessing abortion.

[Not a sex worker but want to know more about what sex work is? Click here]

Abortion is a deeply personal decision—one that can bring up a lot of emotions, questions, and considerations. For sex workers, the reality of navigating abortion care can be even more complex because of ongoing stigma and the criminalization of sex work in many parts of the U.S. We recognize that every experience is unique; our goal is to provide you with the knowledge and resources you need to make the decisions that are best for you.

What does abortion access look like right now?

There are three types of abortions; in-clinic abortion, medication abortion and self managed abortion. All are proven safe, but how easy they are to get really depends on where you live. Some states make it easier to access in-clinic abortions or abortion pills, while others have banned abortion entirely (however, pills by mail is always an option no matter where you live!). Ultimately, you know what’s best for your life—whether that means going somewhere in person or getting pills mailed to you.

What do I need to consider if I’m traveling for an abortion?

Most people have the right to travel between states—unless they are on probation, on parole or under some form of state surveillance. Read more about deciding to travel for an abortion.

If you travel for an abortion—especially if you live in a highly restricted state—or for work, there are additional considerations for sex workers. While there aren’t any federal laws criminalizing sex work itself, there are federal policies that indirectly target sex workers:

• Laws such as the Mann Act and the Travel Act can target sex workers, even when traveling across state lines for unrelated reasons (e.g., seeking medical care).
• Sex workers who are non-U.S. citizens, undocumented, of immigration status, and/or more likely to be racially profiled may face extra risks when crossing state lines. You never have to tell TSA, border agents, or cops why you are traveling. Check out this informative post: “Know Your Rights”.
• The Trafficking Victims Protection Act (TVPA) was designed to protect trafficking victims, but its broad language allows law enforcement to conflate trafficking with consensual sex work. This can lead to raids and arrests of sex workers, criminalizing them, increasing their vulnerability to abuse, and limiting their access to essential services and resources.
• Be mindful of what you share on social media or through text/email about your plans, and consider taking extra steps to secure your devices and data.

How can I make sure my information is kept private and confidential during an abortion appointment?

Abortion providers, like all medical professionals, are required by HIPAA (the Health Insurance Portability and Accountability Act) to keep your information private. No one can join your appointment unless you explicitly agree to it. If you have health insurance and someone else is the policy holder (e.g., spouse, parent, guardian), they may see certain billing information. However, if you choose to self-pay, pay out-of-pocket, or receive funding from an abortion fund, your records will remain private.

Do I need to tell the doctor I’m a sex worker?

Nope. You are never legally required to disclose your employment status to a healthcare provider.

If you do disclose, watch out for possible red flags. Examples include the provider conflating sex work with sex trafficking; blaming your work for unrelated health issues; pressuring you to leave your profession; assuming that you use/abuse alcohol or substances; and/or asking inappropriate, intrusive questions about your sexual history. If you experience any kind of discrimination, you have the right to file a grievance with the healthcare facility or a complaint with your state medical board.

At the clinic, they may question you about your job. If you don’t want to disclose your sex work, you don’t have to! You can make up another profession, say you do gig work, or whatever else feels right to you. Remember, you are allowed and encouraged to set boundaries during your appointment—apply the same skills you use with your clients to keep the appointment focused on your health and not on personal details that don't matter for your healthcare.

How can I make sure my information is private when booking a place to stay?

If you're worried about sharing your ID or other identifying information when booking lodging, consider these tips. First, check Vrbo for places that offer lockboxes or coded entry so you can stay contactless—a feature that's especially helpful if someone else is booking the Vrbo for you. Additionally, consider using an alias, as some hotels don't require ID at check-in.

Programs like SWANS can help you find confidential booking!

What things should I prepare for before and after my abortion?

Plan for time off

If you are a full-service or in-person worker, you may need a few days or more to rest before returning to your routine. If you work mostly online, try to set up some posts ahead of time using social media scheduling tools while you recover.

Financial planning

Do you have a client that might be more open to virtual options, such as digital content, phone sex, or sexting? Consider other platforms or services you can offer that may be more comfortable while you care for yourself. 

Talking to clients

You NEVER have to disclose why you aren’t able to take clients in person or aren’t available on certain days. You should never feel pressured to share the abortion with a client.Let your regulars know in advance that you'll be on vacation and have content ready to share! This is especially helpful if you do a variety of sex work. If you're traveling out of state, consider reaching out to that generous client to book you before you leave.

Need an extra boost after missed wages? Chat with SWANS to see how we can help!

Take care of yourself and monitor your symptoms

It’s common to experience cramping and bleeding for a couple of weeks. Use pads to monitor bleeding (you can have bleeding and spotting for up to 2-6 weeks). Heating pads or a warm compress can help ease the pain of cramps. You may feel relief, sadness, anxiety, joy, or a mixture of emotions. All feelings are valid, and professional or peer-based support can help. Many sex workers build strong communities, so don’t hesitate to reach out to trusted friends or sex workers–led organizations (SWOPLA has support group offerings - reach out to services.swopla@proton.me)

Returning to work

Some doctors recommend avoiding putting anything in the vagina—tampons, penetrative toys, or sexual activities—for at least one week to prevent infection. However, there is no evidence of this increasing your risk of infection. You know your body best so do what feels most comfortable for you.

If you choose to return to in-person work sooner, some sex workers use makeup sponges or specially designed products like Beppy sponges to prevent bleeding. You can have sex with a sponge—there’s no string visible, the client won’t feel it, and it can be softer and more comfortable. If you do have heavier bleeding again, switch back to pads because it’s a better way to monitor. If you’re filling up 4 overnight pads in 2 hours, it could be a sign that you’re hemorrhaging and you may need to go to the hospital.

It’s common to ovulate again within 1-4 weeks after an abortion, so the chances of getting pregnant again are possible, even if you’re still bleeding. Some people may lactate after their abortion. It's more common if an abortion happens after 14-16 weeks but it can also happen earlier in pregnancy. Abortion providers who are providing abortions in the 2nd trimester often give medication to help prevent this, but not always (you can definitely ask them about it!).

I don’t have anyone to talk to about this..

As a sex worker, sharing your decision to have an abortion can feel especially vulnerable. Focus on what feels right for you—whether it’s asking for support or simply telling loved ones. Choose someone you trust and set boundaries around what you’re comfortable sharing about your work and decisions. It’s okay if their reaction isn’t what you expected or hoped for. Prioritize your safety and emotional well-being. Reach out to your local SWOP chapter for support groups (Can’t find one? Ask us!).

SWANS is creating community support for sex workers who have had abortions—reach out to us!

What if I’m worried about needing an abortion in the future?

If you aren’t pregnant now but want to be prepared if you ever are, there is advanced provision of abortion pills. Which means you can order pills before you’re pregnant, so you have them in case you are pregnant in the future.

Wanting more 1-on-1 support?

I Need An A and SWANS want you to feel supported and cared for! While stigma and legal obstacles may make the journey complicated, it’s important to remember you are not alone. There are organizations, hotlines, and fellow sex workers who understand your circumstances and are ready to help! Whether you choose a self-managed abortion, an in-clinic procedure, or something in between, you deserve compassionate, respectful care—without having to compromise your safety or privacy.

Contact SWANS. They provide not only financial aid and trauma-informed peer support for those seeking an abortion, but also flights, hotels, meals, missed wages, and assistance booking and scheduling appointments and travel. This service is FOR sex workers, BY sex workers. You do not have to live in California to receive aid.

• Repro Legal Helpline: get legal questions answered
• M+A Hotline: get medical questions answered
• Reprocare: peer support hotline for people using pills
• SWOP-LA & SWANS: financial, travel, and peer support for sex workers
• All-Options: pregnancy counseling and emotional support
• Digital Defense Fund: online tools to keep you safe

Everybody deserves safe & accessible abortion care! #sexworkiswork

Miscarriages can be incredibly heartbreaking and relieving — there’s no “right” way to feel. They are also incredibly common and normal.

What are normal symptoms of a miscarriage?

• 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

These symptoms can range from minor to severe and could last a few days or weeks.

**** many people pass their miscarriages on their own without medical intervention ****

When is it an emergency?

• If you have very heavy bleeding and soak through more than 2 overnight maxi pads per hour for 2 hours in a row (make sure you are tracking your bleeding by what’s on the maxi-pad and not what’s in the toilet.)
• Running a fever of 101°F or greater
• A really foul smelling discharge + severe pain that isn't better with over the counter pain medications (like tylenol or ibuprofen). These (in addition to a fever) are also signs of infection and should be treated immediately

What do I do if I’m having an emergency?

Go to your OBGYN or the emergency room.

What are my options for treatment during a miscarriage?

1. Watch and wait

Wait for the pregnancy tissue to pass. The uterus will contract on its own and push the pregnancy out.

• Being aware of the potential emergencies + symptoms we listed above.
• Monitor your bleeding with overnight maxi pads
• Take ibuprofen and use a heating pad for cramps
• Monitor your temperature with a thermometer
• Monitor how your body feels and make sure your pregnancy symptoms are going away within a few days.

2. Medication

Doctors can prescribe Mifepristone and misoprostol (the same pills used for a medication abortion) to take at home that induce a miscarriage and empty the uterus. Using misoprostol only is also an effective option for miscarriage management. Read more about the medication process here. If you live in a state where abortion is severely restricted, they may not provide these pills.

3. Procedure

If the pregnancy was less than 12 weeks, a doctor may remove the pregnancy tissue using an in-office procedure, called vacuum aspiration. The cervix is dilated and a gentle suction is used to remove the pregnancy. Typically, sedation can be used to help with pain management. Read more about the procedure here. If you were in the second trimester or later, the procedure would likely be a longer process.

If you live in a state where abortion is severely restricted, you may find physicians hesitate to provide the health care you need.

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!

We also have a database of providers in heavily restricted states where you can get ultrasounds, pregnancy tests, post abortion care and miscarriage management without fear of judgment or threats.

Taking Abortion Pills After 12 Weeks

We are excited to share our new article in partnership with Abuzz that offers comprehensive information about safely and effectively using abortion pills after 12 weeks.

Read Abortion Pills After 12 Weeks here.

This resource is not medical or legal advice; it’s meant to empower abortion seekers with knowledge so they can make informed decisions that feel right for them. Below is an overview of what’s included in this resource, why we created it, and how it can support you or someone you know.

This article contains:

• Evidence-based data
• Legal considerations and privacy tips
• Step-by-step guidance
• What to expect and how to prepare
• Visual aids
• Practical resources

Why This Article Matters

Many U.S. providers cap medication abortion around 12 weeks, but research and real-world experience confirm safety beyond that point. Our goal is to get rid of the shame around abortion and replace it with knowledge that allows people to choose the right path for themselves. In addition to medical facts, we offer emotional and legal support recommendations so no one feels alone.

If you know someone who might need this information, consider passing it along. We welcome questions and suggestions at ineedana@protonmail.com.

But don’t just take our word for how great this article is, check out what our partners say:

Thank you for reading and for being part of a community that values accurate, stigma-free health information!