Possible Side Effects of the Abortion Pill and How to Manage Them

The abortion pill, also referred to as a medical abortion, involves the use of two medications—mifepristone and misoprostol—to safely and effectively end an early pregnancy. This non-surgical option is often recommended for pregnancies up to seven weeks of gestation.

Before taking an abortion pill, it is crucial to understand its side effects, management strategies, and when to seek medical attention to ensure patients feel informed and supported throughout the process.

Abortion Pill Process: What to Expect

The abortion pill process typically begins by taking mifepristone orally in an abortion clinic or under medical guidance. This drug works by blocking progesterone, a hormone necessary for the continuation of pregnancy. As a result, the uterine lining deteriorates, and the pregnancy tissue separates from the uterine wall.

The second medication, misoprostol, is given approximately 24-48 hours after taking mifepristone, either orally or through the vagina. This medication works by contracting the uterus and expelling pregnancy tissue from the vagina. The side effects of medical abortion often begin within a few hours of taking misoprostol.

Common Side Effects and Symptoms of the Abortion Pill

The abortion pill can cause several side effects as the body responds to the medication and the pregnancy is expelled. Individuals should watch out for symptoms, such as:

• Pain and Cramps

  Abdominal pain and cramping are usual occurrences, as the uterus contracts to expel the pregnancy tissue. These sensations can range from mild to intense, similar to heavy menstrual cramps. To alleviate discomfort, doctors may prescribe medications, such as ibuprofen, to reduce pain and inflammation. Applying a heating pad to the lower abdomen can also help soothe cramps and relax the uterine muscles.

• Bleeding and Clotting

  After passing pregnancy tissue, women may also notice blood clots, which can range in size from small to as large as a lemon. It is also common to experience heavy bleeding or spotting, which typically lasts for a few hours before gradually lightening, though some spotting may continue for up to two weeks.
• To accurately monitor bleeding and reduce the risk of infection, use thick sanitary pads instead of tampons during this time.

• Nausea and Vomiting

  Nausea and vomiting may occur within a few hours of taking the second medication, misoprostol. While these symptoms can be uncomfortable, they are usually temporary and tend to resolve within 24 hours. Staying hydrated and getting plenty of rest can help your body cope during this time. If nausea becomes severe, your doctor may prescribe medication such as promethazine, to help manage it.

• Fever or Chills

  A low-grade fever or chills may develop within the first 24 hours after taking misoprostol. This is a normal response to the medication and is typically mild and short-lived, resolving on its own without treatment.

• Fatigue

  Fatigue is a frequent complaint following abortion pills due to the physical and emotional demands of the process. Individuals may feel exhausted or weary for a few days. To support recovery, ensure adequate fluid intake and rest as much as possible, especially in the first 48 hours.

• Diarrhoea

  Diarrhoea can occur as a side effect of misoprostol, but it usually resolves within a day. To manage this, stay hydrated by drinking plenty of water or electrolyte solutions, and avoid heavy or greasy foods that may worsen symptoms. Getting adequate rest can also help your body recover more quickly.

When to Seek Medical Attention

While most side effects of the abortion pill are manageable at home, certain symptoms require prompt medical attention. Contact your doctor if you experience any of the following:

• Heavy or Persistent Bleeding

  Soaking through more than two pads per hour for two consecutive hours or bleeding heavily for more than 12 hours may need medical evaluation.

• Blood Clots

  Passing clots larger than a lemon for more than two hours may indicate a complication.

• Infection

  Fever above 38°C that lasts more than 24 hours, accompanied by flu-like symptoms, may require immediate attention.

The abortion pill is generally a safe and effective option for ending an early pregnancy, especially when taken under the guidance of a qualified medical professional. Most side effects are temporary and can be managed at home with simple care strategies, while serious complications are rare. Taking an abortion pill does not affect future fertility, and many women go on to have healthy pregnancies afterwards.

However, abortion pills may not be suitable for everyone, so it is important to carefully consider your options. If you have questions or concerns about the process or potential side effects, consult an experienced abortion doctor for personalised advice. Remember, you are not alone, and professional care is available to ensure your safety and well-being.

Our Gynaecologist

Dr Jen Shek Wei
Consultant Obstetrician & Gynaecologist

MBBS (S’pore), MMed (OBGYN, S’pore)

FRCS (OBGYN, London),FAM(S)

MBBS (S’pore), MMed (OBGYN, S’pore)FRCS (OBGYN, London), FAM(S)

Dr Jen Shek Wei is an abortion doctor with more than 30 years of experience in the field of OBGYN. At his Ministry of Health (MOH)-accredited clinic, he provides medical abortion (abortion pills) with an attentive follow-up to monitor progress and manage any side effects. Throughout the entire process, Dr Jen is committed to offer compassionate and confidential care for his patients during what is often a difficult and emotional time for them.