What Are Abortion Pills and How Do They Work?

Abortion pills, also called medication abortion, use medicines to end an early pregnancy. The most commonly used combination is mifepristone and misoprostol.

Medication abortion is supported by extensive clinical evidence and is addressed in guidance from organizations including the U.S. Food and Drug Administration (FDA) and the World Health Organization (WHO). However, recommendations can differ depending on the country, healthcare setting, gestational age, applicable regulations, and the specific medication regimen being used.

In the United States, the FDA-approved mifepristone regimen with misoprostol is indicated for ending an intrauterine pregnancy through 70 days (10 weeks) of gestation. WHO's international guidance addresses medication abortion more broadly and includes recommendations concerning self-management of medical abortion under 12 weeks. These are different regulatory and clinical frameworks and should not be treated as interchangeable.

This guide explains what abortion pills are, how they work, who may be eligible, what to expect, when medical care may be needed, and what to consider when accessing medication abortion online.

What Are Abortion Pills?

Abortion pills are medicines used for medication abortion. The FDA-approved U.S. regimen uses two medicines:

• Mifepristone
• Misoprostol

Mifepristone blocks progesterone, a hormone needed for a pregnancy to continue. Misoprostol causes the uterus to contract and helps expel the pregnancy.

The FDA-approved regimen of mifepristone with misoprostol is indicated for ending an intrauterine pregnancy through 70 days, or 10 weeks, from the first day of the last menstrual period.

WHO guidance also recognizes medication abortion using mifepristone plus misoprostol or misoprostol alone and provides recommendations for different healthcare and self-management approaches.

How Do Abortion Pills Work?

The two medicines have different roles.

Mifepristone

Mifepristone blocks progesterone. Without sufficient progesterone support, the pregnancy cannot continue.

Misoprostol

Misoprostol causes uterine contractions. These contractions help the uterus empty.

For the FDA-approved U.S. regimen, the labeled dosing is:

• Day 1: 200 mg of mifepristone taken by mouth.
• 24–48 hours later: 800 micrograms of misoprostol taken buccally, meaning in the cheek pouch.
• About 7–14 days later: follow-up with the healthcare provider.

Medication instructions can differ depending on the regimen and clinical circumstances. People should follow the instructions provided by their healthcare professional and the medication's approved information.

What Is the Difference Between Medication Abortion and Abortion Pills?

Medication abortion refers to the medical process of ending a pregnancy using medicines.

Abortion pills is a common term for the medicines used for that process.

The terms are often used interchangeably in everyday language, but medication abortion describes the treatment process rather than simply the medication itself.

How Effective Are Abortion Pills?

Medication abortion is an established method of ending an early pregnancy. Effectiveness depends on factors such as the medication regimen, gestational age, correct use of the medicines, and individual circumstances.

The FDA-approved mifepristone regimen has been evaluated for medical termination of an intrauterine pregnancy through 70 days of gestation.

No medication works in every individual case. Some people may need follow-up assessment or additional treatment if the abortion is incomplete or if the pregnancy continues.

Because individual circumstances differ, a healthcare professional can provide information about whether a particular medication abortion regimen is appropriate.

When Can Abortion Pills Be Used?

In the United States, the FDA-approved mifepristone and misoprostol regimen is indicated for an intrauterine pregnancy through 70 days (10 weeks) from the first day of the last menstrual period.

WHO's 2025 second-edition abortion care guideline recommends an option for self-management of medical abortion at less than 12 weeks, including self-assessment of eligibility, self-administration of medicines, and self-assessment of abortion completion. WHO also emphasizes access to accurate information, quality-assured medicines, support from trained health workers, and healthcare or referral services when needed.

These recommendations should be understood in their respective contexts. WHO guidance is international and does not change U.S. FDA labeling, state law, or other requirements that may apply in the United States.

Who May Not Be a Candidate for the FDA-Approved Mifepristone Regimen?

The FDA identifies circumstances in which mifepristone, when used with misoprostol for medical termination of pregnancy, should not be used.

These include:

• More than 70 days since the first day of the last menstrual period
• A known or suspected ectopic pregnancy
• Certain problems involving the adrenal glands
• Current long-term corticosteroid therapy
• An allergy to mifepristone, misoprostol, or similar medicines
• Certain bleeding disorders or use of blood-thinning medicines
• Inherited porphyria
• An intrauterine device (IUD) that has not been removed

This list does not replace an individualized medical assessment. A licensed healthcare professional should determine whether the medication is appropriate based on the individual's circumstances.

Why Is Ectopic Pregnancy Important?

An ectopic pregnancy occurs when a pregnancy develops outside the uterus, most commonly in a fallopian tube.

Mifepristone and misoprostol are not a treatment for ectopic pregnancy. The FDA specifically identifies known or suspected ectopic pregnancy as a contraindication to the FDA-approved mifepristone regimen.

Symptoms that may indicate an ectopic pregnancy can include abdominal or pelvic pain, vaginal bleeding, shoulder pain, dizziness, weakness, or fainting. Symptoms can vary, and an ectopic pregnancy can sometimes occur without obvious symptoms early on.

Anyone with symptoms that could indicate an ectopic pregnancy should seek appropriate medical evaluation.

How Are Abortion Pills Taken?

The exact instructions depend on the medication regimen and the healthcare professional providing care.

For the FDA-approved U.S. regimen through 70 days of gestation:

• Day 1

Take 200 mg of mifepristone by mouth.

• 24–48 Hours Later

Take 800 micrograms of misoprostol buccally, according to the instructions provided with the medication and by the healthcare professional.

• Follow-Up

Follow up with the healthcare provider approximately 7–14 days later as directed.

WHO guidance includes additional medication-abortion approaches and routes in international settings. Those recommendations should not be presented as the FDA-approved U.S. regimen.

Always use the regimen and instructions provided for the specific medication and clinical situation.

What Should You Expect After Taking Abortion Pills?

People commonly experience bleeding and cramping after taking misoprostol.

Other effects can include:

• Nausea
• Vomiting
• Diarrhea
• Headache
• Chills
• Fever
• Fatigue

The timing and intensity of symptoms can vary.

Bleeding may be heavier than a normal menstrual period, and cramping can be significant while the uterus is expelling the pregnancy.

Because experiences vary, people should review expected symptoms and warning signs with their healthcare professional before using the medication.

When Should You Seek Medical Care?

Serious complications are uncommon, but it is important to know when medical evaluation is needed.

The FDA advises seeking medical attention for certain concerning symptoms, including:

• Heavy bleeding, such as soaking through two thick full-size sanitary pads per hour for two consecutive hours
• Abdominal pain or feeling sick, including weakness, nausea, vomiting, or diarrhea, particularly when occurring more than 24 hours after taking misoprostol
• A fever of 100.4°F (38°C) or higher lasting more than four hours
• Other symptoms that cause concern or suggest a serious complication

If emergency symptoms occur and the healthcare provider cannot be reached, seek emergency medical care.

When seeking medical care, provide healthcare professionals with accurate information about the medicines taken and when they were taken.

How Do You Know if Abortion Pills Worked?

Follow-up is important because symptoms alone do not always confirm that an abortion is complete.

The FDA-approved regimen recommends follow-up with a healthcare provider approximately 7–14 days after treatment.

Depending on the circumstances, follow-up may involve a clinical assessment, pregnancy testing, ultrasound, or another method recommended by the healthcare professional.

If pregnancy symptoms continue or there is uncertainty about whether the abortion was complete, contact a healthcare professional for appropriate follow-up.

Can Abortion Pills Be Taken at Home?

Medication abortion may be provided outside a clinic in appropriate circumstances.

WHO's current international guidance also recognizes self-management as an option for medical abortion at less than 12 weeks. This can include self-assessment of eligibility, self-administration of abortion medicines, and self-assessment of whether the abortion was successful. WHO states that people self-managing an abortion should have access to accurate information, quality-assured medicines, support from trained healthcare workers, and healthcare or referral services if needed.

In the United States, the FDA-approved mifepristone regimen is indicated for ending an intrauterine pregnancy through 70 days of gestation. The FDA's Mifepristone REMS does not require a patient to have an in-person visit solely to obtain mifepristone. Certified healthcare providers must be able to assess whether a patient is an appropriate candidate and ensure access to appropriate emergency care.

Whether medication abortion can be provided or self-managed, and what requirements apply, can vary based on applicable law, clinical requirements, and the healthcare setting.

Can You Get Abortion Pills Online?

In the United States, mifepristone for medical termination of pregnancy through 70 days is a prescription medication subject to the FDA's Mifepristone REMS Program.

Under the current REMS:

Mifepristone must be prescribed by a qualified healthcare provider who is certified under the program.

Mifepristone may be dispensed by or under the supervision of a certified prescriber.

A certified pharmacy may dispense mifepristone on a prescription from a certified prescriber.

Certified pharmacies must meet specific dispensing and shipping requirements.

The FDA does not recommend obtaining mifepristone outside the legitimate U.S. REMS and prescription system.

When considering online abortion care, it is important to understand:

• Who provides the clinical assessment
• Who determines eligibility
• Who prescribes the medication
• How the medication is dispensed
• Whether the dispensing pharmacy meets applicable requirements
• What follow-up support is available
• How emergency care can be accessed if needed
• Availability and requirements may also vary according to state law and the healthcare service involved.

Can Abortion Pills Be Delivered by Mail?

Under the FDA's current Mifepristone REMS, certified pharmacies may dispense mifepristone by mail when it is prescribed by a certified healthcare provider. Certified pharmacies must be able to use a shipping service that provides tracking information.

Mail delivery does not mean that mifepristone is available over the counter or without a prescription. The FDA states that mifepristone for medical termination of pregnancy through 70 days remains prescription-only.

When accessing medication abortion by mail, patients should understand the healthcare pathway involved, including the clinical review, prescribing process, dispensing pharmacy, medication instructions, and follow-up arrangements.

What Does the Mifepristone REMS Require?

The FDA's Mifepristone REMS Program is a risk-management system that establishes requirements for prescribing and dispensing mifepristone for medical termination of pregnancy through 70 days.

Among other requirements, the REMS provides that:

• Prescribers must meet specified qualifications and become certified.
• The healthcare provider and patient must review and sign the required Patient Agreement Form.
• The patient must receive the FDA-approved Medication Guide.
• Mifepristone must be dispensed by or under the supervision of a certified prescriber or by a certified pharmacy on a prescription from a certified prescriber.
• Pharmacies dispensing mifepristone must meet certification requirements.
• Certified pharmacies must be able to ship mifepristone using a service that provides tracking information.

The FDA removed the previous in-person dispensing requirement in its January 2023 modification of the REMS and added pharmacy certification requirements.

Is Medication Abortion Safe?

The FDA states that mifepristone is safe when used as indicated and directed and consistent with the Mifepristone REMS Program. The agency's review of postmarketing data through December 31, 2024 did not identify any new safety signals.

However, describing a medication as safe does not mean that it is appropriate for every individual or that complications cannot occur.

Medication abortion has contraindications and potential adverse effects. Appropriate eligibility assessment, medication instructions, follow-up, and access to medical care are important parts of the treatment process.

People should discuss their individual circumstances with a qualified healthcare professional.

Medication Abortion vs. In-Clinic Abortion

Medication abortion and procedural abortion are different approaches to ending a pregnancy.

Medication abortion uses medicines, while procedural abortion involves a healthcare procedure to remove the pregnancy from the uterus.

The appropriate option depends on factors such as gestational age, medical circumstances, availability, individual preferences, applicable law, and the options offered by the healthcare professional.

Neither approach should be presented as appropriate for every individual.

Abortion Pills Are Not Emergency Contraception

Abortion pills and emergency contraception are different.

Emergency contraception is used to reduce the chance of pregnancy after unprotected sex or contraceptive failure. It does not end an established pregnancy.

Medication abortion is used to end an existing pregnancy.

Because the medicines, timing, and purposes are different, emergency contraception should not be described as an alternative to medication abortion.

What Should You Consider When Getting Abortion Pills Online?

If you are considering online medication abortion care, review the service carefully before providing personal or medical information.

Consider whether the service clearly explains:

Clinical Review

Understand who reviews your information and determines whether medication abortion is appropriate.

Prescribing

Confirm who prescribes the medication and whether the healthcare professional meets applicable requirements.

Medication Information

Review the medication names, dosing instructions, contraindications, expected effects, and warning signs provided with your treatment.

Pharmacy and Dispensing

Understand how and where the medication is dispensed and, when applicable, whether the pharmacy participates in the relevant regulatory requirements.

Follow-Up

Find out what follow-up support is available and how you can contact the healthcare team if you have questions.

Emergency Care

Know where to seek medical care if you develop symptoms that require urgent evaluation.

Privacy

Review how personal and health information is collected, stored, and used before submitting sensitive information online.

These considerations can help people understand the healthcare pathway rather than relying solely on a website's marketing claims.

What Is the Role of Pill Access?

Pill Access facilitates access to online abortion care by connecting individuals with licensed healthcare professionals who independently review relevant information and eligibility.

Medical decisions, prescribing, and clinical care are provided independently by licensed healthcare professionals. Pill Access does not make individual medical decisions on behalf of patients.

The healthcare professionals involved determine whether medication abortion is appropriate based on the individual's information and applicable clinical requirements.

Availability and eligibility can vary based on applicable state law, clinical requirements, and current service availability.

Frequently Asked Questions

What are abortion pills?

Abortion pills are medicines used for medication abortion. The FDA-approved U.S. regimen uses mifepristone followed by misoprostol for ending an intrauterine pregnancy through 70 days of gestation.

What medicines are used for medication abortion?

The most commonly used combination is mifepristone and misoprostol. WHO also includes misoprostol-only medication abortion in its international guidance.

How far along can you be to use abortion pills?

The FDA-approved mifepristone regimen in the United States is indicated through 70 days, or 10 weeks, from the first day of the last menstrual period. WHO's international guideline addresses medical abortion under 12 weeks and includes recommendations concerning self-management.

Can abortion pills be taken at home?

Medication abortion may be provided outside a clinic in appropriate circumstances. WHO also recommends an option for self-management of medical abortion at less than 12 weeks when the relevant conditions and support are available. U.S. availability and requirements depend on applicable law, clinical requirements, and the healthcare setting.

Can abortion pills be ordered online?

Online medication abortion services may involve remote clinical assessment and prescription. In the United States, mifepristone remains subject to the FDA's Mifepristone REMS and prescription requirements.

Can abortion pills be mailed?

Under the current FDA REMS, mifepristone may be dispensed by certified pharmacies and may be shipped by mail using a service with tracking information.

Do abortion pills work for an ectopic pregnancy?

No. Mifepristone with misoprostol is not a treatment for ectopic pregnancy. Known or suspected ectopic pregnancy is a contraindication to the FDA-approved mifepristone regimen.

What happens after taking abortion pills?

Bleeding and cramping are expected effects of medication abortion. Other effects can include nausea, vomiting, diarrhea, chills, fever, headache, and fatigue.

When should I seek medical care?

Seek medical care for concerning symptoms, including very heavy bleeding, persistent high fever, significant or worsening pain, or other symptoms that may indicate a complication. The FDA specifically identifies heavy bleeding and prolonged fever among symptoms requiring medical attention.

How do I know if the abortion was complete?

Follow-up is important because symptoms alone may not confirm that an abortion is complete. The FDA-approved regimen recommends follow-up with a healthcare provider approximately 7–14 days after treatment.

Is medication abortion the same as emergency contraception?

No. Emergency contraception is intended to prevent pregnancy after sex or contraceptive failure. Medication abortion is used to end an existing pregnancy.

Does Pill Access make medical decisions?

No. Pill Access facilitates access to online abortion care by connecting individuals with licensed healthcare professionals. Medical decisions, prescribing, and clinical care are provided independently by licensed healthcare professionals.

The Bottom Line

Abortion pills are an established form of medication abortion using medicines such as mifepristone and misoprostol.

In the United States, the FDA-approved mifepristone regimen with misoprostol is indicated for ending an intrauterine pregnancy through 70 days of gestation and remains subject to prescription and Mifepristone REMS requirements. The FDA permits dispensing by certified pharmacies, including dispensing by mail.

WHO's current international guidance recognizes a broader range of medication-abortion approaches and recommends an option for self-management of medical abortion at less than 12 weeks, provided people have access to accurate information, quality-assured medicines, trained support, and healthcare or referral services when needed.

Because laws, clinical requirements, and healthcare services vary, anyone considering medication abortion should obtain information appropriate to their circumstances and understand how to access follow-up and emergency care if necessary.

Medical Disclaimer

This article is provided for general educational purposes and is not a substitute for individualized medical advice, diagnosis, or treatment.

Medication abortion involves prescription medicines and may not be appropriate for everyone. Eligibility, medication selection, dosing, and follow-up should be determined according to the applicable clinical guidance and the individual's circumstances.

If you have symptoms that may indicate a medical emergency, seek appropriate medical care promptly.

Medical information can change as clinical evidence, regulatory requirements, and healthcare guidance are updated. This content should be reviewed periodically by a qualified healthcare professional.