General Warnings

Signs Your Medical Abortion Didn’t Work

What is Medical abortion?

Medical abortion, also known as medication abortion, is a non-surgical method of ending a pregnancy through the use of medication. It involves taking two different types of pills to terminate a pregnancy. The first medication, mifepristone, is taken orally to block the hormone progesterone, which is necessary for maintaining a pregnancy. The second medication, misoprostol, is usually taken 24-48 hours after the mifepristone and causes contractions to expel the pregnancy. Medical abortion is typically used in the early stages of pregnancy and can be done in a clinic or at home, under the guidance of a healthcare provider.

This method can be used up to 24 weeks of pregnancy. What to expect depends on whether the pregnancy is less than or more than 10 weeks gestation. You can obtain these medications through doctors and clinics that provide abortion services, like Planned Parenthood. You should never buy them online or on the black market. The cost of the medication depends on location and additional tests or follow-ups that may be necessary. According to Planned Parenthood, abortion procedures can cost up to $800. However, this cost fluctuates depending on the area where you live.

How will I feel after taking the abortion pill?

For most people, medication abortion feels like having an early miscarriage. You might have:

•          lots of cramping and aches in your belly

•          very heavy bleeding with large clots (If you don’t have any bleeding within 24 hours after taking the second medicine, misoprostol, call your nurse or doctor.)

•          an upset stomach and vomiting (Your doctor or nurse may give you medicine to help with nausea.)

•          diarrhea

•          dizziness

•          tiredness

•          mild fever (99-100° F) or chills on the day you take the misoprostol (If you have a fever after the day you take the misoprostol pills, call your doctor or health center right away.)

To help ease pain and make you more comfortable, you can:

•          Take pain medication like ibuprofen (Advil or Motrin). Don’t take aspirin because it can make your bleeding worse.

•          Put a heating pad or hot water bottle on your belly.

•          Take a shower.

•          Sit on the toilet.

•          Have someone rub your back.

Can an abortion pill fail?

Yes, abortion pills can fail especially when they are not used correctly or when they are used with other substances or drugs that affect how they work. When misoprostol and mifepristone are used together, they have about a 98 percent effectiveness rate. While this effectiveness rate is high, it’s possible for a medical abortion to fail to terminate a pregnancy. In these cases, a woman would need to then undergo a surgical abortion.

The age of the pregnancy, the medication doses and administration, and whether or not a woman has been pregnant before may impact the effectiveness. The effectiveness rate decreases for each additional week of pregnancy.

How To Know If The Abortion Pill Didn’t Work

An abortion pill can fail to work correctly leaving some pregnancy tissue in the womb a condition known as incomplete abortion. This causes painful symptoms that need medical attention as soon as possible.

Here are some of the signs of incomplete abortion. Seek help from a medical professional if you experience these symptoms after taking an abortion pill:

  • A fever
  • Lower abdominal pain 
  • Moderate to severe vaginal bleeding (saturating more than one pad an hour)
  • Pain in the back, buttocks, genitalia, and perineum 
  • Passing blood clots

What are the side effects of the abortion pill?

Potential risks of medical abortion include:

  • Incomplete abortion, which may need to be followed by surgical abortion
  • An ongoing unwanted pregnancy if the procedure doesn’t work
  • Heavy and prolonged bleeding
  • Infection
  • Fever
  • Digestive system discomfort.

You must be certain about your decision before beginning a medical abortion. If you decide to continue the pregnancy after taking medications used in medical abortion, your pregnancy may be at risk of major complications.

Medical abortion hasn’t been shown to affect future pregnancies unless complications develop.

Medical abortion isn’t an option if you:

  • Are too far along in your pregnancy. You shouldn’t attempt a medical abortion if you’ve been pregnant for more than nine weeks (after the start of your last period). Some types of medical abortion aren’t done after seven weeks of pregnancy.
  • Have an intrauterine device (IUD).
  • Have a suspected pregnancy outside of the uterus (ectopic pregnancy).
  • Have certain medical conditions. These include bleeding disorders; certain heart or blood vessel diseases; severe liver, kidney or lung disease; or an uncontrolled seizure disorder.
  • Take a blood thinner or certain steroid medications.
  • Can’t make follow-up visits to your doctor or don’t have access to emergency care.
  • Have an allergy to the medications used.

A surgical procedure called dilation and curettage (D&C) may be an option for women who can’t have a medical abortion.


Joan David-Leonhard

Joan David Leonhard is a recent Pharm.D graduate with a strong passion for the pharmaceutical industry and a particular interest in pharmaceutical media and communication. Her brief internship experience includes roles in pharmacy where she built strong patient-pharmacist relationships and a pharmaceutical media internship where she actively contributed to drug information articles, blog posts, social media engagement, and various media projects.
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