Medical abortion is when a pregnant person takes medication to end a pregnancy. It differs from a surgical abortion, in which tissue from the pregnancy is removed from the uterus during a surgical procedure. Another term for medical abortion is Plan C.
What Is a Medical Abortion?
Medication to terminate a pregnancy typically involves two drugs: mifepristone (Mifeprex, RU-486, “the abortion pill”) and misoprostol (Cytotec). Mifepristone stops progesterone, a hormone needed to sustain pregnancy. Misoprostol tells the uterus to contract to empty its contents. Cervical dilation (opening) also happens at this time, allowing for the tissue to be expelled from the uterus. The drugs are taken 24 to 48 hours apart.
A medication abortion can be done up to 11 weeks from the first day of your last menstrual period, according to Planned Parenthood, though some insurers will cover the cost only up to seven weeks.
The U.S. Food and Drug Administration (FDA) approves the use of abortion pills for up to 10 weeks. One small study found that medication abortion was effective for those in their 13th to 15th week of pregnancy, but researchers have called for more studies on this topic.
Many physicians will recommend medical abortion no later than 10 weeks in the outpatient setting; later it may be done in a supervised hospital setting so health practitioners can monitor the pregnant person’s status.
If you are not sure how much time has passed since the first day of your last period, you can ask your healthcare provider about a pregnancy test and ultrasound to determine fetal age and your options.
If you're concerned about the cost, check with your health insurer to determine its policy regarding medical abortion.
According to Planned Parenthood, the effectiveness of a medical abortion varies depending on how far along the pregnancy is:
- For someone 8 weeks pregnant or less, it is effective in 94–98 out of 100 people.
- For someone 8–9 weeks pregnant, it is effective in 94–96 out of 100 people.
- For someone 9–10 weeks pregnant, it is effective in about 91–93 out of 100 people. If an extra dose of medicine is taken, as directed by a medical professional, it is effective in 99 out of 100 people.
- For someone 10–11 weeks pregnant, it is effective in about 87 out of 100 people; with extra medication, it is effective in about 98 out of 100 people.
A medical abortion can take up to a full day. If it is not successful, talk to your provider about additional medication or about surgical abortion.
Taking medication to terminate a pregnancy is safe, effective, private, and convenient, according to the Guttmacher Institute.
A medical abortion can cause you to feel tired and crampy for a day or so, with bleeding and spotting happening for some time afterward. You can return to work, school, and normal activities the next day after the abortion is complete, but avoid hard work or heavy exercise for a few days.
Is Medical Abortion the Same as Emergency Contraception?
Medical abortion is not emergency contraception. Medical abortion ends a pregnancy, which is defined as the implantation of an embryo in the uterine lining. Emergency contraception, taken up to five days after sex, prevents pregnancy by preventing or delaying ovulation or, in some cases, preventing sperm from reaching and fertilizing an egg, according to the U.S. Office on Women's Health.
RELATED: Emergency Contraception Basic Facts
How to Obtain a Medical Abortion
With the growth of telehealth during the COVID-19 pandemic, researchers have found that it is safe and effective to have a medical abortion at home. Depending on your state’s laws and provider’s policies, you may also obtain a prescription for the medications needed for a medical abortion from a healthcare provider, who may want you to come into the office to take the medications. If your provider wants to see you in person, you'll take the medication in the office, then return to the office later to confirm the procedure was successful.
The following resources can help you find more information about medical abortion:
Who Can Have One?
Anyone who is pregnant and is within 70 days of the first day of the last menstrual period is eligible for a medical abortion, according to the American College of Obstetricians and Gynecologists (ACOG). Medical abortion is not restricted to people of a certain age, and is effective for both single and twin pregnancies.
Medical abortions are common, and in 2020 made up 54 percent of all abortions in the United States — up from 39 percent in 2017.
They first became available in September 2000, when the FDA approved mifepristone for the termination of early pregnancy. “This one advancement in medicine has changed the landscape of how people obtain and experience abortion in this country,” per a Guttmacher Institute report.
Who Is Not Eligible for Medical Abortion?
People with a diagnosed or suspected ectopic pregnancy, which is a pregnancy that develops outside the uterus, cannot take standard medication abortion: They need to seek medical care, because an ectopic pregnancy can be life-threatening.
A medication abortion is also not recommended in the following situations:
- You're undergoing treatment with corticosteroids.
- You have an intrauterine device (IUD) in place (though it can be removed before a medication abortion).
- You have chronic adrenal failure.
- You have a bleeding disorder or are taking medication to treat a bleeding disorder.
- You have a blood disorder called inherited porphyria.
- You're allergic to the drugs used in a medication abortion, according to ACOG.
People with anemia have not been studied in research on medication abortion. Others living with chronic conditions should ask their healthcare providers if they need extra monitoring before, during, or after a medication abortion. And finally, you must: be able to follow the instructions for a medication abortion; have enough time to allow the medication abortion process to play out; and be able to stay in touch with the healthcare provider overseeing the procedure.
How Much Does It Cost?
The cost of a medical abortion depends on your insurance coverage, how far along you are in the pregnancy, where you obtain the medication, and other factors. Your local Planned Parenthood clinic can help you figure what you'll pay; the organization says the treatment can cost up to $750.
Research conducted from 2017 to 2020 and published in Health Affairs in April 2022 noted that the median medical abortion cost rose from $465 to $560 during that time.
If you cannot afford this healthcare (or to travel for it), talk to your doctor and reach out to an abortion fund.
RELATED: How to Find Trustworthy Abortion, Emergency Contraception, and Birth Control Resources
Risks and Benefits
Depending on where you live and what your state laws are, you can decide to get a medication abortion as soon as you learn you are pregnant. You can take the medication at home or at a friend’s home and can rest there when the cramping and bleeding happen.
Potential Side Effects and Complications
Unlike a surgical abortion, which is a fairly quick procedure (about 10 minutes), a medical abortion takes a few days to complete. The pills used in a medication abortion have been used for the past 20 years and are considered safe.
But there are a few risks, and some rare side effects, to consider. The pregnancy may remain in place; some of the pregnancy tissue may not leave your body; uterine blood clots may form; you may have heavy or extensive bleeding; or you may develop an infection or find you're allergic to one of the drugs used. Fortunately, these complications are typically easy to treat.
Speak with a healthcare provider right away if the following rare issues occur: no bleeding within a day of taking the second drug; very heavy bleeding for more than two hours in a row; very heavy clots for more than two hours; intense cramps or belly pain; a high fever more than a day after taking medication; any weakness, nausea, vomiting, or diarrhea for more than a day after taking medication.
Taking medication to end a pregnancy does not affect your future ability to get pregnant. In fact, because it is possible to become pregnant soon after a medical abortion, experts recommend using a birth control method as soon as possible afterward.
RELATED: Best and Worst Birth Control Options
Keep Your Private Information Private and Safe
If abortion is not legal in your state, or may not be legal much longer, use extra care. According to Cooper Quintin, a senior staff technologist at the internet and civil liberties–focused nonprofit Electronic Frontier Foundation (EFF), there are some safe ways to search for information.
- Use the Tor browser or a privacy-protective search engine such as DuckDuckGo.
- Search in incognito or private browser mode.
- If you visit a clinic or provider, turn location services off, or turn your phone off.
- For texting about private health information, experts recommend using an encrypted messaging platform, like Signal or WhatsApp, with disappearing messages.
For more information about privacy and keeping your data safe, go to EFF’s Surveillance Self-Defense guide.
Resources We Love
These networks know how to operate safely and discreetly and have been doing so for years.
ACN connects hundreds of independent abortion clinics across the United States. Their hotline is 202-419-1444.
NAF is another network of trustworthy abortion providers. Hotline: 800-772-9100
An online directory of vetted healthcare providers.
This directory lists reputable abortion providers. ACO's hotline: 800-455-8130
This organization connects you with clinics, providers, and information. Their hotline: 800-230-PLAN (7526)
This bilingual English and Spanish site can help you identify a nearby provider who speaks either language.
The Alliance will link people 15 weeks pregnant or more with transportation, food, and other logistical coordination needed to get an abortion.