Facing an unplanned pregnancy can feel overwhelming. If you’re considering the abortion pill, it’s important to understand how it works, what to expect, and the potential risks involved before making a decision.

This guide walks you through what you need to know before taking the abortion pill, how the process works, what happens during and after, possible side effects and complications, and when to seek medical care. Having accurate information can help you make a confident, informed choice about your next steps.

What to Know Before Taking the Abortion Pill

Before the abortion pill, several important medical steps are recommended:

Get an ultrasound. For your safety, an ultrasound is required prior to receiving the abortion pill per North Carolina’s state law. An ultrasound confirms how far along the pregnancy is and helps rule out conditions such as miscarriage or ectopic pregnancy (when the pregnancy develops outside the uterus). An ectopic pregnancy is a medical emergency and cannot be treated with abortion pills.
Have a medical consultation. A qualified healthcare professional should screen you for conditions that make the abortion pill unsafe, including ectopic pregnancy, certain anemias, bleeding disorders, adrenal failure, long-term steroid use, an IUD in place, or allergies to the medications used.

Test for Sexually Transmitted Infections. Untreated STIs like chlamydia or gonorrhea during abortion raise risks of pelvic inflammatory disease (PID). PID causes scarring that can lead to chronic pain, infertility, or ectopic pregnancies in the future.[1]

How Does the Abortion Pill Work?

The abortion pill—also called a medication abortion—uses two prescription drugs: mifepristone and misoprostol.[2]

Mifepristone is taken first. It blocks progesterone, a hormone needed to sustain a pregnancy, causing the pregnancy to stop developing.
Misoprostol is taken 24–48 hours later. It causes the uterus to contract and expel the pregnancy tissue.

The FDA approves the abortion pill for pregnancies up to 10 weeks (about 70 days from your last period).[2]

How Long Does the Abortion Pill Take to Work?

While every woman’s experience is different, a typical timeline looks like this:

Day 1: Mifepristone is taken, usually at a clinic or doctor’s office.
24–48 hours later: Misoprostol is taken at home.[2]
Within 2–24 hours of misoprostol: Cramping and bleeding usually begin.[3]
Afterward: Light bleeding or spotting may continue for 9–16 days, and in some cases up to 4 weeks.[4]

How Much Bleeding Is Normal After an Abortion?

Bleeding is expected with the abortion pill, but the amount can vary depending on how far along the pregnancy is.

When bleeding starts: Usually within 2–24 hours after taking misoprostol.[3]
How long it lasts: Heavy bleeding may last several hours, followed by lighter bleeding or spotting for up to two weeks or longer.[3]
When to call a doctor: If you soak through two full-size pads per hour for two consecutive hours, seek medical care right away. This could indicate hemorrhaging.

Medication abortion typically causes heavier and longer bleeding than a surgical abortion.[5]

Abortion Pill Side Effects

Like any medical procedure, the abortion pill carries side effects and potential complications.

According to one study, 29% of women who took the abortion pill experienced adverse effects, such as a fever or heavy bleeding, and 43% of women had to seek additional medical care.[10]

Common side effects include[3]:

Cramping
Bleeding or spotting, which can last up to a month
Nausea or vomiting
Diarrhea
Headaches
Chills or low fever

Serious Risks

Allergic reaction: Rare but potentially life-threatening reactions, including anaphylaxis, can occur.[6]
Hemorrhage: Excessive bleeding that requires emergency care.[7]
Incomplete abortion: Retained pregnancy tissue may require surgery to prevent infection.[8] One study showed that 18% of women required a D&C after taking the abortion pills.[10]
Infection: Symptoms such as persistent fever, abdominal pain, nausea, vomiting, or diarrhea lasting more than 24 hours after misoprostol may signal infection.[3]

Possible Psychological Risks of the Abortion Pill

Everyone experiences abortion differently. The abortion procedures can be traumatic for some women, thus exacerbating emotions you may already be experiencing.[11] Other times, an abortion could cause new emotional or mental health conditions.[12] These could include:[13][14]

Depression
Anxiety
Low Self-Esteem
Substance Abuse
Suicidal Behaviors

If you’re having thoughts of suicide, call the Suicide and Crisis Lifeline at 988 immediately.

When to Call a Doctor

Pay attention to your body during and after the process. Call your doctor immediately if you notice[9]:

Soaking through two pads per hour for two hours or more
Severe or worsening abdominal pain
Fever of 100.4°F or higher lasting more than four hours
Persistent nausea, vomiting, diarrhea, weakness, or flu-like symptoms after misoprostol

These symptoms may indicate complications such as infection, hemorrhage, or incomplete abortion and require prompt medical care.

Considering the Abortion Pill in Carthage, North Carolina? Contact Life Care Pregnancy Center.

An unplanned pregnancy can bring fear and uncertainty, but you don’t have to face it alone. At Life Care Pregnancy Center, we provide accurate information, medical-grade pregnancy services, and compassionate support so you can explore all your options with confidence.

Call us at (910) 947-6198 or book an appointment online today.

Please be aware that Life Care Pregnancy Center does not provide or refer for abortion services.

Frequently Asked Questions About the Abortion Pill

How painful is the abortion pill?
Pain levels vary. Most women experience moderate to strong cramping similar to—or more intense than—a heavy period, especially after taking misoprostol.
Can you take the abortion pill at home?
Misoprostol is typically taken at home, but prior medical screening, accurate ultrasound dating, and follow-up care are strongly recommended for safety and required per state law.
Is the abortion pill safe without an ultrasound?
An ultrasound is important to confirm how far along the pregnancy is and to rule out ectopic pregnancy, which can be life-threatening if untreated.
What happens if the abortion pill doesn’t work?
If the abortion is incomplete or continues, additional medication or surgical intervention may be required to prevent infection or complications.
Are there alternatives to the abortion pill?
Yes. Parenting and adoption are options many women consider, and support services are available to help you understand what each path could look like for you.

Sources

1. Mayo Clinic. (2022, April 30). Pelvic inflammatory disease (PID). https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
2. FDA. (2025, February 11). Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation?sm_guid=NTU1NzgyfDYzMDE1OTM2fC0xfGppbUBha2ZhbWlseS5vcmd8NTY4OTI4MXx8MHwwfDE5OTYwMDk4OHwxMDg2fDB8MHx8NTQ3NzI2fDA1
3. U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html
4. Danco Laboratories, LLC. (2022). MEDICATION GUIDE: Mifeprex. Danco Laboratories, LLC. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020687s014lbl.pdf
5. Mayo Clinic. (2025, February 1). Mifepristone (oral route). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123
6. Bridwell, R. E., Long, B., Montrief, T., & Gottlieb, M. (2022, October 23). Post-abortion Complications: A Narrative Review for Emergency Clinicians. The Western Journal of Emergency Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC9683756/
7. Shin, Hyun Joo, et al. “Anaphylactic Shock to Vaginal Misoprostol: A Rare Adverse Reaction to a Frequently Used Drug.” PubMed Central (PMC), 9 Aug. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6137020
8. Danco Laboratories, LLC & FDA. (2016, March). Mifeprex Label. FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf
9. Mayo Clinic. (2022, July 29). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
10. Kapp, N., Andersen, K., Griffin, R., Handayani, A. P., Schellekens, M., & Gomperts, R. (2021). Medical abortion at 13 or more weeks gestation provided through telemedicine: A retrospective review of services. Contraception: X, 3, 100057. https://doi.org/10.1016/j.conx.2021.100057.
11. Fergusson DM, Horwood LJ, Boden JM. Abortion and mental health disorders: evidence from a 30-year longitudinal study. British Journal of Psychiatry. 2008;193(6):444-451. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abortion-and-mental-health-disorders-evidence-from-a-30year-longitudinal-study/59A90CBF3A58C58B342CBCFFBBFEBD2E
12. Mota, N. P., Burnett, M., & Sareen, J. (2010, April). Associations Between Abortion, Mental Disorders, and Suicidal Behaviour in a Nationally Representative Sample. American Association of Pro-Life Obstetricians and Gynecologists. https://www.aaplog.org/wp-content/uploads/2011/11/Mota-et-al.pdf
13. Fergusson, D. M., Horwood, L. J., & Ridder, E. M. (2005, September 22). Abortion in young women and subsequent mental health. Association for Child and Adolescent Mental Health. https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/j.1469-7610.2005.01538.x
14. Coleman PK. Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009. British Journal of Psychiatry. 2011;199(3):180-186. doi:10.1192/bjp.bp.110.077230.

Helping women and men in the Sandhills know their options.