If you have an intrauterine contraceptive device in the uterus (e.g. the coil IUD or the progesterone IUD) you must get it removed. IUDs must be removed before taking abortion pills.
If you are breastfeeding a baby, the misoprostol pills may cause diarrhea in the baby. To avoid this, breastfeed the baby, take the misoprostol pills, and wait 4 hours before you breastfeed again.
If you are living with HIV, just make sure you’re not getting sicker, you’re on antiretroviral medicines, and your health is otherwise good.
If you have anemia (have low iron in your blood), identify a health care provider who is no more than 30 minutes away that can help if you need it. If you are very anemic, consult a doctor before using abortion pills.
If you are concerned about keeping your abortion as private as possible, use the abortion pill in the sides of your mouth between your teeth and cheeks instead of vaginally. In the unlikely situation that you have a complication and have to seek medical aid, the tablets may still be visible if used in the vagina. In some countries, you could be reported if pills are found in your vagina.
Drink plenty of water through the whole process.
When you use the misoprostol pills, be in an area (like your home) where you have privacy and can lie down for a few hours after you use the pills if you want.
Eat lightly (e.g. crackers or toast may help with nausea).
Having someone with you who can look after you may be helpful.
Consider taking ibuprofen before you use misoprostol to help minimize pain from cramping.
Make a safety plan before using the abortion pills in case you need emergency medical help.
According to the American Congress of Obstetricians and Gynecologists, a first trimester medical abortion is one of the safest medical procedures. However, you should always be prepared for any possible medical emergency. Consider our questions below to help create your safety plan in case you need it.
Where is the nearest 24 hour emergency medical center?
You need to be able to get there within 1 hour or less. (If you have anemia, you should be able to get there within 30 minutes.)
How will you get to your emergency medical center?
Will someone be with you that is able to drive? Will you take a taxi? Public transportation? How much will it cost and will it be available 24 hours? Remember, it is not safe to drive yourself to the hospital during a medical emergency.
What will you tell your doctors?
Is medical abortion or at-home abortion legally restricted where you live? What can you say to your doctors so that they understand the help you need, but that protects your privacy? We have some suggestions if you need help thinking of what to say.
What To Tell Your Doctors?
In some countries, medical abortion or at-home abortions are legally restricted. This means that if you need emergency medical help, you may need to be careful about what you say. Medical abortion has the same symptoms as a natural miscarriage (also known as a spontaneous abortion). Therefore, you can say things like
- I'm unsure what's happening. I just started bleeding.
- I'm bleeding, but it doesn't feel like my normal period.
- I just suddenly started bleeding and I'm afraid something is wrong.
- “Induced Abortion.” American College of Obstetrics and Gynecologists. https://www.acog.org/Patients/FAQs/Induced-Abortion
- “Care for Women Choosing Medication Abortion.” The Nurse Practitioner. https://journals.lww.com/tnpj/Citation/2004/10000/Care_for_Women_Choosing_Medication_Abortion.9.aspx
- “Safe abortion: technical and policy guidance for health systems.”The World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/70914/?sequence=1