How to Know If the Abortion Pill Worked: Complete Medical and Emotional Guide

Understanding Medical Abortion and What to Expect

The use of the abortion pill can be accompanied by feelings of anxiety and uncertainty for the user. Many may ask themselves, “how do i know if abortion pill worked?” Knowing what to expect during your medical abortion and what to look for regarding your body will reduce stress and help ensure you are safe throughout this process.

Medical abortions typically consist of two separate medication doses, with mifepristone being taken first to block out the hormone (progesterone) that maintains the pregnancy. Misoprostol is taken second and causes the woman to contract and ultimately pass the tissue. If used as directed, this procedure is over 90 percent effective for pregnancies up to 10 weeks.

Knowing what is considered normal versus abnormal is important in order to ensure you recover from your procedure. In the next section you will learn about the signs your abortion went successful, when you should experience these things after your abortion, and when you should call for help. 

What are the Signs the Abortion Pill Worked?

Everyone may not exhibit the same symptoms of success. However, below are the most common signs you may experience: 

Symptom	What It Means
Heavy bleeding and cramping	Cramping starts after misoprostol and is a sign that your uterus is contracting to pass the pregnancy.
Passing blood clots or tissue	Blood clots or tissue may vary in size; this is a normal part of the process.
Gradual reduction in bleeding	Bleeding should slowly lighten over days to a couple of weeks.
Pregnancy symptoms fade	Symptoms like nausea, breast tenderness, or fatigue typically diminish within 1–2 weeks.

Most of the time having one, or most commonly all, of the following signs will indicate that you had a successful abortion.

How effective are abortion pills?

Using mifepristone and misoprostol as an abortion method is highly effective and very safe.

Effectiveness is:

• 98 – 99% if used for terminated pregnancies less than 70 days.
• Slightly less than 98 – 99% if a terminated pregnancy is between 70 – 77 days.
• Mifepristone/misoprostol combinations yield the same level of effectiveness if instructed correctly, however, additional doses may be required if using misoprostol alone.

When taken as recommended, adults do not require extra treatment.

How can you be sure it worked?

You can confirm whether the procedure worked using one of these methods:

How can you be sure it worked?

You can confirm whether the procedure worked using one of these methods: 

 

What to do
Perform an at-home pregnancy test	Four weeks after you took the pills; testing sooner may have a false positive due to the delay between the end of pregnancy hormone (hCG) levels and when they drop off.
Assess your pregnancy symptoms	Your pregnancy symptoms should be significantly declining within 1-2 weeks.
Determine hCG blood levels	You will need to have a blood hCG test done before administering the mifepristone and then again approximately 5-7 days afterwards; a significant drop in your hCG blood levels will verify that the abortion has happened successfully.
Get an ultrasound	At least two weeks post-treatment unless your health care provider tells you otherwise; having an ultrasound prior to the two-week mark may result in an unclear result.

Important:

It’s common to continue to have a positive test for several weeks after your abortion; therefore, it does not mean that you are still pregnant or that you have miscarried. Your hormones will not evaporate immediately upon pregnancy termination. 

If you were very early (less than 5 weeks) in your pregnancy, your test may turn negative more quickly than later-established pregnancies.

What to do if you don’t think the pills worked

When having any concern with your possible incomplete abortion; Call your provider. If they make a recommendation, it could be one of the following options: 

• You may need to wait a little longer
• There may be a need for additional dosage of Miso
• There may be a need for laboratory testing or ultrasound 

Signs to be aware of:

If any of the following occur, contact your provider immediately: 

• Heavy bleeding that hasn’t slowed down
• Severe cramping that hasn’t subsided
• Fever or chills after first 24 hours
• Symptoms of pregnancy persist 

Most incomplete abortions can be treated safely through extra dosages of Medications.

When to Seek Medical Attention

Serious complications from using Misoprostol are rare. However, contact your local Emergency Room for immediate treatment if you see any of the symptoms below:

Symptom	Action
Severe abdominal pain or fainting	Go to the emergency room
Bleeding soaking 2+ pads per hour for 2+ hours	Contact provider immediately
Fever above 101°F lasting more than 24 hours	Call your provider or ER
Persistent pregnancy symptoms	Follow up with provider
Weakness, nausea, or vomiting continuing after cramping	Seek medical attention

24 hours or more after taking misoprostol

Contact the healthcare provider if you have:

• Bleeding or cramping that has not improved
• Developed a fever after the first 24 hours
• Belly pain that is continuing to get worse
• Weakness, nausea or diarrhea for longer than 24 hours

1 week after taking the pills

Contact the provider if you do:

• Not feel that you passed the pregnancy
• Not see any decreased pregnancy symptoms
• Continue to bleed or cramp with no decreasing amounts
• Continue to feel uncertain or have ongoing concerns

What’s Normal vs. Not Normal

Normal:

• Heavy bleeding for many hours
• Passing clots
• Severe cramping
• Nausea, diarrhea, fever or chills in the first 24 hours
• Bleeding for up to 14 days
• Positive HPT at < 4 weeks

Not normal:

• Very heavy bleeding that does not get less
• Severe pain one side
• Fever after 24 hours
• Getting worse in condition rather than getting better

Still Not Sure? Serenity Choice Health Is Here for You

You do not have to go through this alone if you need help understanding your symptoms, or just want assurance.

At Serenity Choice Health, we know that after taking abortion pills there can be many questions, fears and doubts about your experience, which is totally normal. Our clinical team will provide you with accurate answers to your questions, medical information for what to expect and compassionate support from us at every level.

You may need help with:

• Understanding the symptoms you may be experiencing
• Information regarding testing you may need
• Support when you are bleeding either more or less than expected
• Evaluation regarding if you are experiencing an incomplete abortion
• Or simply want to know what you are experiencing is normal.

Our providers can guide you through what is happening to your body and assist you to develop a plan for what to do next. If you are feeling uneasy, or just want some reassurance, please reach out to Serenity Choice Health. We care about your confidence and safety first, so we are here for you.

Frequently Asked Questions (FAQs)

How many days of breast pain after abortion?

Breast tenderness typically lasts for approximately 1—2 weeks, but varies according to the rate of hormone clearance.

How long after abortion will a pregnancy test be positive?
Pregnancy hormones can remain in your system for up to 4 weeks after an abortion, which would cause a false positive on a urine pregnancy test if taken too soon.

What if I took misoprostol and nothing happened?
Please consult your physician for a follow-up appointment. You may require close monitoring, as well as an additional dose of misoprostol.

How to tell if medical abortion worked?

You will see a reduction in cramps, decrease in bleeding, resolution of pregnancy symptoms and should follow-up with a urine pregnancy test or ultrasound.

How long do cramps last after taking misoprostol?

Cramping usually occurs most strongly during the first 4—6 hours, and generally reduces over 1—2 days.

How long after an abortion do pregnancy symptoms go away?

Most pregnancy symptoms begin improving within a few days, but breast tenderness and hormonal symptoms can take 1–2 weeks to fully resolve.

Checkout Our Full Guide: Your Abortion Experience: Before, During & After Care Guide

Final Thoughts

A medical abortion can be performed safely and successfully if it is performed properly. Make sure to be aware of how you feel, keep track of your symptoms and test at the appropriate time to confirm whether or not the abortion pill worked. It’s just as important to take care of your emotional health as it is to take care of your physical health, so get in contact with someone if you need to. If you are aware of the signs of recovery and what you should do if you experience an abnormality, the chances of having a safe and comfortable recovery will increase.