Risks at home

These medicines are taken outside a clinic. There is no recovery room down the hall. There is no in-state elective clinic to finish what pills started if something is incomplete. This page is expected bleeding versus hemorrhage, what failure looks like on the label, and why leftover tablets are not a plan. It is not a set of steps to follow. It is not a vendor list.

A nurse can talk with you in chat, or write back on the form. Free and private. You decide.

Talk with a nurse — free, private.

Get the facts. You will not be pressured here.

Expected bleeding is not proof you are fine

Uterine bleeding happens in almost all patients after both medicines. Average bleeding or spotting: 9 to 16 days. Heavy bleeding median: 2 days. Up to 8% have some type of bleeding more than 30 days. Often heavier than a heavy period. Heavy bleeding requiring surgical evacuation: about 1%. About 85% report at least one adverse reaction. Those figures are for the approved two-medicine regimen, not after the first pill alone.

Soak through two thick full-size sanitary pads per hour for two consecutive hours: that is an ER. If you are crashing before the second hour, do not wait. Fever of 100.4°F or higher lasting more than 4 hours belongs there too. Tell the ER you took the abortion pill — mifepristone, misoprostol, or both, if you know.

Serious and sometimes fatal infections and bleeding occur very rarely following spontaneous, surgical, and medical abortions, including after mifepristone. No causal relationship between the use of mifepristone and misoprostol and these events has been established. Prolonged heavy bleeding may be a sign of incomplete abortion. Serious infection can present without fever.

Bleeding and cramping can look like a miscarriage. They can also be a ruptured ectopic. Symptom overlap is not “just a miscarriage.”

The regimen is not treatment for ectopic pregnancy. A ruptured ectopic can be fatal. A positive test is not a location. One-sided pain or pain at the tip of your shoulder is an ectopic concern. Treat it as an ER.

FDA labeling says follow-up about 7 to 14 days after mifepristone is very important. Lack of bleeding usually indicates failure. Prolonged or heavy bleeding is not proof of a complete abortion. If listed contacts cannot be reached, go to an ER.

Fainting is an ER. Ordinary dizziness is expected. If you cannot stay upright when you stand, treat that like fainting and call 911.

If the pills fail

On the label’s U.S. trials (n = 16,794), complete medical abortion was 97.4%, surgical intervention 2.6%, ongoing pregnancy 0.7%. About 2 to 7 out of 100 women taking Mifeprex will need a surgical procedure because the pregnancy did not completely pass or to stop bleeding. Those are Table 3 figures, not a universal real-world rate. Complete-abortion rates in Table 4 fall as gestational age rises toward 70 days.

It is unlawful for any person to intentionally perform or attempt an abortion in Alabama except as the Human Life Protection Act provides. Pills are not a lawful elective abortion here. There is no in-state elective clinic to finish what pills started. We do not sell, ship, or name vendors. This is not legal advice.

No woman upon whom an abortion is performed or attempted shall be criminally or civilly liable under this Act. Still tell the ER what you took.

If pregnancy continues after the regimen, FDA labeling says the risk of fetal malformation is unknown; birth defects have been reported after failed Mifeprex-plus-misoprostol. Cytotec separately reports congenital anomalies after unsuccessful use of misoprostol as an abortifacient. Do not call mifepristone a proven teratogen. Misoprostol has been associated with those anomalies if pregnancy continues. That needs a clinician, not a website prognosis.

Leftover misoprostol is a danger, not a plan. Do not take a friend’s tablets.

Rh — do not assume you should skip it

FDA labeling assumes the same Rh prevention used for surgical abortion. ACOG’s 2020 bulletin recommended testing and RhIg. ACOG issued a 2024 update for pregnancies under 12 weeks that suggests forgoing routine testing and RhIg while still allowing individual shared decision-making. If your blood type is unknown or Rh-negative, and you may want more children, ask a clinician. Do not assume you should skip it.

That ACOG 2024 line is ACOG, not the FDA label. This page is not adopting lighter follow-up as if it were the label.

If you are bleeding now and stable enough to read, If you are bleeding now. After: After the pills. Why a scan first: Why an ultrasound first. For more of the law, see Can I get an abortion in Alabama?.

If you have taken only mifepristone and you want this pregnancy to continue, that conversation lives on Changed your mind after the first pill?.

A nurse is here.

> Emergency. Soak two thick pads an hour for two consecutive hours, fainting, severe pain, or fever of 100.4°F or higher lasting more than 4 hours: 911. If you are crashing before the second hour, do not wait. If you may harm yourself, 988.

A nurse can use an interpreter. We write in English first.

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We do not sell, ship, or name vendors. Independent centers named here are not a chain.

Chat is not medical care. An emergency room is.

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