An Abortion at Home

An abortion, or pregnancy termination, can take place at home or in a healthcare setting. This depends on how early or advanced the pregnancy is. Up to 20 weeks into a pregnancy, it’s possible—and safe—to have an abortion at home with pills. This is also called a medication abortion or a medical abortion. 

After 10 weeks, depending on where you live, it’s still possible to have a medication abortion in a healthcare facility. But after 12 weeks, the only option for ending a pregnancy is through a surgical procedure in a healthcare clinic. 

Here’s a look at how home abortions work, the medications used, and when it’s safe to have one. 

Are at-home medication abortions safe?

Yes, home medication abortions are safe. In the U.S., pregnancy can be terminated safely and legally at home up to week 10 of pregnancy. The FDA has approved a medication regimen for up to 10 weeks (70 days or less since your last menstrual period). But some places may go beyond this. 

The only safe way to have an abortion at home is with medications prescribed by a trained medical professional after a consultation. The consultation may be in person at a hospital or clinic. This can also happen by phone or telehealth appointment.

Are at-home abortions legal?

At-home abortions for pregnancies 10 weeks or less are legal in most states in the U.S. But laws are changing around this. Even in states where at-home abortions are legal, laws may now require a physician to be present when you take the first medication. 

Afterwards, you can usually go home and wait for the medication to take effect. And you can take the second medication at home. 

How do you have a medication abortion at home?

A medication (home) abortion involves taking two medications. Unlike a surgical abortion, which is a same-day procedure, a medication abortion takes longer. 

Typically, you’ll manage the outcome and symptoms at home over 2 to 3 days. So it’s important to understand the steps and timeline so you know what to expect. 

Step 1: Take mifepristone

Here are the details of the first step:

• Take a 200 mg pill of mifepristone by mouth. 

• Depending on your preference and state laws, this might be at home or in a clinic. 

• This medication stops the pregnancy from growing. 

• There are minimal symptoms at this stage. But you might have some light spotting or cramping.

Step 2: Wait 24 hours 

Here’s what to expect next:

• This is a good time to rest and prepare for the next couple of days.

• Make sure you have supplies, like sanitary pads, a heating pad, and acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). 

• Try to anticipate what kind of emotional support you may need. You may want to be alone, or you may want to have a support person there with you.

Step 3: Take misoprostol

Here’s what happens next:

• Take four 800 mcg pills of misoprostol. These pills can be placed in your vagina, under the tongue, or inside the cheeks. 

• Misoprostol starts to work within a few hours. 

• This medication will cause some cramping and bleeding that will push the pregnancy out of your body.

Step 4: Manage symptoms at home

Here are the details of the fourth step:

• Cramping and bleeding will be most intense on the first day. 

• You may also experience some diarrhoea, nausea, dizziness, or fatigue in the first 24 hours. 

• You’ll want to be near a bathroom and have acetaminophen or ibuprofen available if needed. 

• Symptoms should lighten up over the following days. 

• Some cramping and bleeding will likely continue for up to a few weeks. 

Step 5: Take a pregnancy test

Here are the details of the last step:

• Around 2 weeks later, take a pregnancy test to make sure the abortion is completed. 

• Make a plan for the birth control option that’s best for you.  

How does the abortion pill work?

Medical abortions usually involve a combination of two pill medications that work together to end a pregnancy: 

• The first medication, mifepristone, blocks the main hormone (progesterone) that maintains the pregnancy. 

• The second medication, misoprostol, causes contractions (cramping) that empty the uterus. It usually causes vaginal bleeding, like a heavy period, within 4 to 6 hours after you take it. 

The two-step medication abortion takes between 2 and 3 days to work. But you will likely have a longer period of light bleeding or cramping. If you were experiencing pregnancy symptoms such as nausea or vomiting, these symptoms should go away within a couple of days after the abortion.

How effective are home abortions?

The two-step abortion medication is 96.7% effective. If it doesn’t work and you don’t get a heavy bleed removing the pregnancy, then some people need another dose of misoprostol or a surgical procedure (surgical abortion) to end the pregnancy. The further along you are in your pregnancy, the more risk there is that a medication abortion might not work.