An abortion, or pregnancy termination, can take place at home or in a healthcare setting — depending on how early or advanced the pregnancy is. It is possible — and safe — to have an abortion at home with pills (also called a medication or medical abortion) up to 10 weeks into a pregnancy.
After 10 weeks, it is still possible to have a medication abortion in a healthcare facility, depending on where you live. Beyond 12 weeks, though, the only option for terminating a pregnancy is through a surgical procedure in a healthcare clinic.
Here’s a look at how at-home abortions work, which medications are used, and when it’s best to avoid an at-home abortion.
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What types of at-home abortions are safe?
Pregnancy can be terminated safely and legally at home in the U.S. up to 10 weeks pregnant. The FDA has approved a medication regimen for up to 10 weeks (70 days or less since your last menstrual period), though some places may give it beyond this.
Abortion Pills 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, or it can happen by phone or a telehealth appointment.
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Are at-home abortions legal?
At-home abortions for pregnancies 10 weeks or less are legal in most states in the U.S., though 19 states require a physician to be present when the pregnant person takes the first medication. Afterward, you can usually go home and wait for the medication to take effect, and take the second medication at home.
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How does the abortion pill work?
Medical abortions usually involve a combination of two pill medications:
- The first medication, mifepristone, blocks the main hormone (progesterone) that maintains the pregnancy.
- The second medication, misoprostol, causes contractions (cramping) that empty the uterus. You take it 1 to 2 days after the first pill. It usually causes vaginal bleeding, like a heavy period, 4 to 6 hours after you take it.
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How long does the abortion pill take to work?
Abortion Pills first pill will stop the pregnancy from growing, and the second pill helps remove the pregnancy. The two-step medication abortion takes between 2 and 3 days to work, though you will likely have a longer period of light bleeding or cramping.
How effective is the abortion pill?
Abortion Pills 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 an additional 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.
Do you need a prescription for the abortion pill?
The abortion pill is regulated by the FDA and requires a prescription. In some states, a physician must write the prescription, which means that nurse practitioners, physician assistants, and midwives are unable to issue the medications. Additionally, as mentioned above, in some states you are required by law to take the medications under direct physician supervision.
Where can you get the abortion pill?
The abortion pill can be provided by a clinic, a hospital, or a doctor’s office (or by mail order, in some states). In the past, step 1 could only be provided by a clinic, a hospital, or a doctor’s office, with the option of picking up step 2 in a retail pharmacy. Since the pandemic, new federal rules now allow for step 1 and step 2 to be prescribed by mail in states where this is legal.
Can you buy the abortion pill online?
Abortion Pills U.S., using telehealth for the full course of abortion care is possible in 22 states. Telehealth is not an option in the 19 states that require that the mifepristone be given in the presence of a physician. Some other states require counseling or an ultrasound scan before a pregnancy can be terminated, which means a pregnant person has to go to a medical office at least once.
Telemedicine visits can be effective and safe. Research done in Europe has shown that people using telehealth and taking medications for abortion at home are very good at identifying complications and seeking medical attention when needed.
While some businesses offer people the option to order pills online, it is important to make sure that the medication is prescribed by a trained healthcare provider. FDA-approved treatments have been tested for safety and approved by scientists and health professionals. Herbal treatments and home procedures carry risks of infection, of bleeding, and may also be ineffective, leading to the need for additional intervention.
Who should not have a home abortion?
There are some people who should not have a medication abortion at home. It is not recommended for people with the following risk factors:
- A pregnancy that has progressed too far along (usually over 10 weeks)
- An ectopic pregnancy (a pregnancy outside of the uterus)
- An intrauterine device (IUD) in place
- Hormonal imbalance, such as from adrenal gland problems or long-term corticosteroid use
- Bleeding problems, such as clotting disorders or concurrent use of blood thinners
- Allergies to either mifepristone or misoprostol
What are the risks of an at-home abortion?
An at-home medication abortion under the guidance of a trained healthcare professional has minimal risks. Many people experience bleeding and cramping after ending a pregnancy. This is a normal part of the uterus returning to its nonpregnant state.
If bleeding is severe, and a person soaks more than one tampon or pad every hour, they should seek medical care. If the uterus doesn’t completely empty itself with the medication abortion, then a surgical procedure may be required to end the pregnancy. This happens in about 2% of cases.
Infections are rare with medication abortions. But they can happen if the uterus doesn’t fully empty and the cervix doesn’t close completely. Look for warning signs like fever, severe pain, a bad-smelling vaginal discharge, fatigue, or chills. These could all be indications that you need follow-up emergency medical care.
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