What it is
A medical abortion uses two medicines taken in sequence under a doctor's guidance. The first (mifepristone) blocks the hormone that keeps a pregnancy going. The second (misoprostol) causes the uterus to contract and empty. In India this method is generally used in early pregnancy, commonly up to about nine weeks (63 days) from the first day of the last period.
Who it may be suitable for
Your doctor will consider how far along you are, your medical history, your blood group, and whether you can reach emergency care if needed. Medical abortion may not be advised if the pregnancy cannot be confirmed to be inside the uterus, if you have certain bleeding disorders or are on long-term steroids, or if you have an allergy to the medicines. These are reasons for an examination, not for a general rule.
Why a scan comes first
An ultrasound confirms how many weeks pregnant you are and that the pregnancy is in the uterus. An ectopic pregnancy, which grows outside the uterus, is not treated by these medicines and can become an emergency. Taking tablets without a scan can hide that danger.
What people commonly experience
Cramping and bleeding are expected, often heavier than a normal period, and may include clots. Nausea, diarrhoea and a mild temperature can occur on the day. Most people feel well enough to resume normal activity within a few days, though bleeding or spotting can last for a couple of weeks. A follow-up is needed to confirm the abortion is complete.
Medical abortion does not always work first time. A small proportion of people need a further dose or a short surgical procedure to complete it. The doctor should explain this possibility before you start.
Get urgent help if you soak two or more large pads an hour for two hours in a row, have severe pain that tablets do not ease, a fever that lasts more than a day, foul-smelling discharge, or feel faint. See abortion aftercare for the full list.
Medical or surgical?
Both are safe in appropriate hands. Medical abortion avoids a procedure but takes place over hours or days at home, with more bleeding. Surgical abortion is quicker and has a lower chance of needing a repeat treatment. Surgical versus medical abortion sets the differences out side by side.
Who medical abortion may not suit
A doctor will usually advise against the pill method, or advise extra precautions, if there is a suspected ectopic pregnancy, an intrauterine device in place, a bleeding or clotting disorder, long-term steroid treatment, anticoagulant medicines, severe anaemia, or an allergy to the medicines. These checks are the reason a scan and consultation come first.
If you are Rh-negative
Your blood group matters. People who are Rh-negative may need an anti-D injection to protect future pregnancies. Ask for your blood group to be checked and tell the doctor if you already know it.
What is usual and what is not
- Usual: cramps, bleeding heavier than a period for several hours, passing clots, nausea, mild fever or chills for a day, and spotting for up to two weeks.
- Not usual, call or go to hospital: soaking two large pads an hour for two hours in a row, fever that lasts more than 24 hours, severe pain not eased by the advised painkiller, foul-smelling discharge, fainting, or no bleeding at all after the medicines.
Follow-up is part of treatment
A review, usually after one to two weeks, confirms that the pregnancy has passed completely. Do not skip it. If tissue remains, it can be treated early and simply. See aftercare and recovery and the medical abortion timeline and checklist.
Common questions
Can I buy the tablets and take them myself?
This is not advised. Without a scan and a clinician's guidance you cannot rule out an ectopic pregnancy or know whether the dose and timing are right.
Will it affect future pregnancies?
Uncomplicated medical abortion is not known to reduce later fertility. Fertility can return within two weeks, so contraception should be planned.
Up to how many weeks can the abortion pill be used?
In India the standard medical abortion regimen is approved up to 9 weeks (63 days) of pregnancy, under a registered doctor's guidance.
How long does bleeding last after the abortion pill?
Heavy bleeding usually lasts several hours, then lightens over days. Spotting can continue for up to two weeks.
How do I know the abortion is complete?
A follow-up check, sometimes with a scan, confirms it. Do not rely on bleeding alone.
General information. This page is educational and does not replace advice from a doctor who has examined you. Read our medical disclaimer.