Abortion Pill
How Does the Abortion Pill Work?
The abortion pill consists of two different medications: mifepristone and misoprostol. This two-drug regimen works by interrupting the pregnancy process and causing the uterus to expel the developing embryo.
First Medication: Mifepristone
Mifepristone is taken first. This medication reduces the amount of the hormone progesterone to the embryo. Progesterone is essential for preparing and maintaining the uterine lining that supports the developing embryo. Without a steady supply of progesterone, the embryo stops growing and eventually dies.[2]
Second Medication: Misoprostol
Misoprostol is taken 24-48 hours following mifepristone which causes the uterus to contract expelling the embryo or fetus depending on the gestational age of the pregnancy.
What to Expect When You Take the Abortion Pill
Here’s a typical timeline for the abortion pill:
- Mifepristone is taken first, followed by misoprostol 24–48 hours later.
- Cramping and bleeding start within 2-24 hours of taking misoprostol.[4] For most women, this process finishes within a day, but it can take longer for some. Everybody is different, so the exact timing varies.[5]
- Bleeding can begin as early as 2 hours after taking misoprostol.[6]
- Heavy bleeding may last a few hours, with lighter bleeding or spotting for 9–16 days. In some cases, spotting can continue for up to a month.[7]
When to Seek Emergency Care
Contact emergency medical services immediately if you experience[8]:
- Heavy bleeding: Soaking through two pads hourly for two hours or more.
- Ongoing sickness: Severe stomach pain, fatigue, nausea, vomiting, and diarrhea for longer than 24 hours after taking misoprostol may indicate an infection or ectopic pregnancy.
- Fever: A temperature of 100.4°F or higher for more than 4 hours after taking misoprostol.
These signs could mean complications like infection or incomplete abortion, which need immediate medical treatment.
Is Abortion Legal in Kentucky?
At the time of writing (2022), abortion is not legal in Kentucky[2].
Click here to learn more about why you should get an ultrasound before an abortion.
Can I Get Abortion Pills Over the Counter?
No, a prescription from a provider or physician who is registered to prescribe the abortion pills is necessary. However, the FDA does permit pharmacies to become certified to dispense the abortion pill with a proper prescription[1].
Can I Order the Abortion Pill Online?
The FDA advises against ordering the abortion pill online. Many online abortion pill providers are located overseas, so the pills they provide may not meet FDA standards[3]. These pills could be counterfeit, expired, or even tampered with. It’s best to err on the side of caution and avoid ordering the abortion pill online.
How Late Can You Take the Abortion Pill?
The abortion pill is only FDA-approved for pregnancies up to 10 weeks (70 days) from your last menstrual period.[9]
If you take the abortion pill later in your pregnancy, the risk of serious complications increases significantly. This is why determining accurate gestational age and viability through ultrasound is so important before considering any abortion procedure.
How Effective is the Abortion Pill?
The abortion pill successfully ends a pregnancy in about 95-98% of cases when within the proper timeframe.[10] However, this means that it can fail in 2-5% of cases.
Women may need additional treatment, which may include surgical intervention.
Abortion Pill Risks and Side Effects
Common Side Effects
Most women experience some side effects after taking the abortion pill, including[11]:
- Bleeding that can last up to a month
- Headaches
- Nausea and vomiting
- Diarrhea and digestive pain
- Chills
- Fever
- Abdominal cramping (caused by the misoprostol)
Serious Complications
While rare, serious complications can occur and may include:
- Severe allergic reaction to the medication[12]
- Hemorrhaging (excessive bleeding)[13]
- Incomplete abortion (remaining pregnancy tissue)[14]
- Infection (fever lasting more than 24 hours)[15]
Understanding these risks and having access to emergency medical care if complications arise is important.
How Much Does the Abortion Pill Cost?
The abortion pill can cost between $150 and $1,100 without insurance.[16] Prices vary based on:
- Local medical abortion costs
- Individual healthcare provider pricing
- Required follow-up appointments and care
- Additional medications or services needed
Can I Get Abortion Pills Over the Counter?
No, you cannot get abortion pills over the counter at any pharmacy or retail location. A provider or physician certified to prescribe abortion pills must give a prescription. This requirement exists because medical abortion requires proper medical supervision and follow-up care.[17]
The FDA allows some pharmacies to dispense the abortion pill. This is only with a prescription from a certified provider.[18] The prescription requirement ensures that:
- Your pregnancy is confirmed and properly dated
- You don’t have medical conditions that make the abortion pill unsafe for you to take
- You receive proper instructions for taking the medications
- Follow-up care is available to ensure the procedure is complete
Can I Order the Abortion Pill Online?
The FDA strongly advises against ordering abortion pills online from uncertified sources.[19] Many online abortion pill providers operate overseas, so the pills they offer may not meet FDA safety standards.
Risks of Online Abortion Pills
Online abortion pills from uncertified sources could be:
- Counterfeit medications with unknown ingredients
- Expired or improperly stored
- Tampered with
- Incorrect dosages
- Completely fake with no active ingredients
These risks can lead to serious health complications, including incomplete abortion, severe bleeding, infection, or continued pregnancy.
Is the Abortion Pill Legal in Kentucky?
Currently, abortion is illegal in Kentucky. However, exceptions can be made in the case of life endangerment to the pregnant woman.[20]
We recommend receiving an ultrasound before taking the abortion pill. Keep reading to learn why.
Can the Abortion Pill be Reversed?
Yes, the abortion pill can be reversed in some cases.
Abortion pill reversal aims to counteract the effects of mifepristone, the first dose in the abortion pill regimen. The reversal protocol is for those who have ONLY taken the first drug (mifepristone).
The treatment involves prescribing natural progesterone supplements to restore hormone levels, potentially allowing the pregnancy to continue. Natural progesterone competes with mifepristone for receptor sites. This helps the embryo stay attached to the uterus and continue to grow.[21]
If you have taken mifepristone but want to continue your pregnancy, act quickly. Contact the Abortion Pill Reversal Network’s 24/7 helpline at (877) 558-0333 or email help@apr.life immediately
Why Should You Have an Ultrasound Before an Abortion?
Before considering any abortion procedure, including the abortion pill, it’s crucial to receive an ultrasound.
An ultrasound provides the information needed to make a safe and informed decision by:
Confirming the Pregnancy
A urine pregnancy test confirms the prescense of HCG pregnancy hormone. An ultrasound confirms that a pregnancy is occuring in the uterus and is viable.
Determining Gestational Age
Accurate dating is essential because the abortion pill is only FDA-approved for pregnancies up to 10 weeks. An ultrasound gives the best estimate of gestational age. This may be different from calculations based on your last period.
Ruling Out Ectopic Pregnancy
An ectopic pregnancy occurs when the embryo implants outside the uterus, most commonly in the fallopian tubes.
This condition poses a life-threatening risk and doctors cannot treat it with abortion pills. An ultrasound can identify ectopic pregnancies that require immediate medical attention.
Abortion Pill Information in Kentucky
When your pregnancy test comes back positive, it can be easy to panic. Don’t let fear make the final decision for you. Get the care and support you deserve at Care Net Pregnancy Services of Northern Kentucky. We offer free pregnancy resources, so you can make an empowered decision for your unplanned pregnancy:
- Free pregnancy tests
- Free ultrasounds
- A safe, non-judgemental place to explore your pregnancy options and share what’s on your mind
Call us at (859) 282-9878 or schedule your appointment online today. All services are confidential and free of charge!
Please be aware that Care Net Pregnancy Services of Northern Kentucky does not provide or refer for abortion services. We are dedicated to giving you accurate information and helpful care. This will assist you in making the best choice for your situation.
Sources
- FDA. (2025, February 11). Questions and Answers on Mifeprex. U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifeprex
- See source #1.
- See source #1.
- U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html
- Mayo Clinic. (2025, February 1). Mifepristone (oral route). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123
- See source #4.
- See source #4.
- Mayo Clinic. (2022, July 29). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
- See source #1.
- Fjerstad M, Sivin I, Lichtenberg ES, Trussell J, Cleland K, Cullins V. Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days. Contraception. 2009;80(3):282–286. https://pmc.ncbi.nlm.nih.gov/articles/PMC3766037/
- See source #4.
- Shin, Hyun Joo, et al. “Anaphylactic Shock to Vaginal Misoprostol: A Rare Adverse Reaction to a Frequently Used Drug.” PubMed Central (PMC), 9 Aug. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6137020
- FDA. (2019, July). Prescribing Information for Mifeprex. U.S. Food & Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/022348s014lbl.pdf
- See source #8.
- See source #4.
- As advertised by abortion providers in December 2025.
- Center for Drug Evaluation and Research. (2025, January 17). Mifeprex (Mifepristone). U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information
- See source #17.
- See source #17.
- Commonwealth of Kentucky Office of the Attorney General. (2022, June 24). Human Life Protection Act. Attorney General Daniel Cameron. https://www.ag.ky.gov/Press%20Release%20Attachments/Human%20Life%20Protection%20Act%20Advisory.pdf
- Delgado G, Davenport ML. Progesterone use to reverse the effects of mifepristone. Ann Pharmacother. 2012;46(12):e-pub ahead of print. https://stenoinstitute.org/wp-content/uploads/2025/08/Article-Annals-of-Pharmacotherapy-APR.pdf