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How to Self-Manage an Abortion with Misoprostol

Updated: Apr 19

Abortion medications are in the news lately. You may have heard that a Texas judge has tried to block FDA-approved mifepristone, a common medication used in the self-managed abortion protocol. There are two protocols approved by the WHO for self-managed medication abortions: #1: mifepristone + misoprostol or; #2: misoprostol alone. Both are completely safe protocols to manage your abortion at home.

To clarify, mifepristone is still available and the Texas ruling has not gone into effect. However, the news has sparked many people to inquire about the misoprostol-only abortion protocol. The good news is that the WHO has provided guidelines for an abortion with misoprostol alone. Self-administring the pills on your own is completely safe but you may have some questions. Below you'll find details on how to manage the abortion with misoprostol.

Determine how far along you are

The first step is to determine how far along you are in your pregnancy. There are a few ways to calculate this, but the easiest way is to start with the first day of your last normal period. From this date, you'll count the number of weeks to get you to today's date. Misoprostol is approved for use up to 12 weeks of pregnancy, so getting an accurate date is important. You may also have your doctor assist with this, if you're unsure.

Obtain misoprostol

If you are within that 12 week period, your next step will be to obtain the misoprostol medication. It's best to purchase 12 tablets (200ug each).

There are a number of places to order abortion pills online in the United States. Aid Access is a great resource to help you locate such abortion-pill delivery services. Plan C is also a great resource and has a very useful interactive map which will help you locate abortion pills depending on where you live in the United States. If you live in a restrictive area, you may want to consider ordering abortion pills for future use and you can do that now.

Take the pills

Have 12 tablets (200ug each) on hand. Take 4 misoprostol pills either under your tongue or between your cheek and gum (2 pills on each side of your mouth) and let dissolve for 30 minutes.

After 30 minutes, swallow any remaining pieces of pills with water. Wait 3 hours, then repeat. Wait 3 more hours, then repeat again. To reduce pain and cramping you can take ibuprofen before or just after taking the 4 misoprostol pills.

Know what to expect

Misoprostol starts working about 30 minutes to a few hours after you take it and you will often experience bleeding, cramps, diarrhea or vomiting during this time. Having pain medication, anti-nausea medications, warm hot pad, comforting teas and anything else that will help you feel taken care of is recommended when you start your process.

It's a good idea to let a trusted friend or family member know that you'll be taking the abortion pills so that they can support you through the process. Even if you decide to take them alone; having someone to talk to before, during and after the process can be very beneficial. They may also be available if you need to go to the doctor for any reason.

Understand the signs

Within 24 hours after you take misoprostol, it’s normal to experience cramping, bleeding, fever, chills, nausea, vomiting or diarrhea. If you have taken the pills correctly, according to this guide, it is not likely that you will need to see a doctor. However, you should see a doctor right away if you are experiencing heavy bleeding; that is, soaking more than 2 pads in two hours. On the flip side, you should also contact a doctor if you have not started bleeding at all within 24 hours.

If after 2-3 days you are still experiencing nausea, feeling sick, or your pain is not getting better, you should contact your doctor. Finally, if you are still experiencing pregnancy symptoms 2 weeks after taking the abortion medications, you should see a doctor.

Self-administering and managing your own abortion is completely safe however knowing a trusted provider that you can reach out to is recommended!

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