What is a self-managed abortion?

https://shoutyourabortion.com/stories/A self-managed abortion is an abortion that you can do yourself with medication.

 

Two medications are used:

  • Mifepristone is used to stop the pregnancy hormones.
  • Misoprostol is used to make the uterus contract.

 

An abortion with medication is very safe and effective. It successfully ends 98% of pregnancies.

 

Read personal accounts of how people feel about their abortions.

 

Since 2015, #ShoutYourAbortion has been using social media to take away the stigma, fear, and shame associated with making the choice to abort.  Tens of thousands from all over the world have shared their experiences.  Their stories may help you feel confident about the process and your decision.   

 

Preparing for your self-managed abortion

Plan ahead

  • Read “How to use abortion pills.” (Keep scrolling.)
  • Try to schedule Step 2 (the day you take misoprostol) when you can be at home or in a comfortable place with access to a private bathroom. 
  • Make a plan for what to do if you need medical care: Where can you go? How will you get there? Can someone go with you? How will you pay for it?

 

Supplies to have ready

  • Ibuprofen for pain
  • Dramamine for nausea
  • Thick menstrual pads 
  • Hard candy to suck on and cover the taste of the misoprostol. 
  • Money for transportation in case you need to seek medical help

How to use abortion pills if you are LESS THAN 11 weeks pregnant

Step 1:

Mifepristone (1 pill)

  • Swallow the pill with water.

 

You may have some light bleeding, spotting or cramping, or nothing at all.

Step 2:

Take 4 misoprostol pills 24 to 48 hours after Step 1. It is very important for you to wait 24 hours between Step 1 and 2!

 

  • 1–2 hours before you take misoprostol, eat a meal. Take anti-nausea medication (Dramamine 50–100 mg) and pain relievers (600–800 mg ibuprofen). 
  • Put the misoprostol pills between your cheek and gums or under your tongue and leave for 30 minutes.
  • Do not eat or drink while you have the misoprostol pills in your mouth. You can suck on a hard candy during this time to help with the bitter taste.
  • After 30 minutes, drink water and swallow the pills left in your mouth.

Step 3:

Take 2 misoprostol pills 3 hours after Step 2

 

  • Put the misoprostol pills between your cheek and gums or under your tongue and leave for 30 minutes.
  • After 30 minutes, drink water and swallow the pills left in your mouth.

How to use abortion pills if you are MORE THAN 11 weeks pregnant

Step 1:

Mifepristone (1 pill) 

  • Swallow the pill with water.

 

You may have some light bleeding, spotting or cramping, or nothing at all.

Step 2:

Start this step 24 to 48 hours after Step 1. It is very important for you to wait 24 hours between Step 1 and 2!

 

  • 1–2 hours before you take misoprostol, eat a meal. Take anti-nausea medication (Dramamine 50–100 mg) and pain relievers (600–800 mg ibuprofen). 

  • Put 2 misoprostol pills between your cheek and gums or under your tongue and leave for 30 minutes.

  • Do not eat or drink while you have the misoprostol pills in your mouth. You can suck on a hard candy during this time to help with the bitter taste.

  • After 30 minutes, drink water and swallow the pills left in your mouth.

  • Repeat taking 2 pills every 3 hours until the abortion is complete.  Read How to know if the pills worked? and you can contact your support person if you have questions.

What if I'm Rh negative?

 

If you have Rh negative blood type and you're over 11 weeks pregnant, you must follow up with a provider to receive a RhoGAM shot within 72 hours after the abortion is complete. You can get this at your local ER or OB provider. Don't tell them you had an abortion: instead say you had a miscarriage after a positive pregnacy test. 

 

If you are Rh negative and fewer than 11 weeks pregnant at the time of your abortion, a RhoGAM shot is not necessary. 

What to expect after you take the medication

  • Bleeding and cramping will start 30 minutes to several hours later and will usually last for about a day. You may have heavier bleeding for a few days and then bleeding like a period for a week or two.
     
  • Nausea, diarrhea, a slight fever and fatigue are normal effects of the medication.

 

Taking the abortion pills at less than 6 weeks

 

Taking medication abortion pills less than 6 weeks since your last period is safe and effective. It can sometimes be hard for you to tell if the pills worked because your bleeding and cramping may be light, often less than a regular period. The pregnancy will not be noticed as it will be the size of a poppy seed at 4 weeks, at 5 weeks the size of an apple seed and 6 weeks the size of a pea. 

You will know the pills worked if:

  • You had cramping or bleeding, even if very mild
  • Your pregnancy symptoms (breast tenderness, nausea) are lessening
  • You have a negative pregnancy test in 4-6 weeks

 

The decision of when to take the pills is yours. Please contact your support person through Signal if you have questions.

Warning signs and symptoms

Fever (above 100.4°F or 38°C) lasting over 24 hours even after taking fever medication (Tylenol, ibuprofen)  

Severe pain that keeps you from your regular activities and does not go away after taking 600-800 mg ibuprofen. (Heavy cramps and pain after Step 2 is normal. This pain should diminish within 24 - 48 hours.)

Extremely heavy bleeding. If you soak more than 2 overnight pads per hour for 2 hours in a row (the pad is full, front to back & side to side). 

Remember: If you go to a healthcare facility, do not reveal that you took pills to cause an abortion.

There is no way to tell that you took the pills. Say that you think you are having a miscarriage. Miscarriages are common, and their treatment is the same as for abortion.

After Your abortion… what’s next?

  • You can go back to regular activities like work or school as soon are you feel ready—for many people, the next day. 

  • Heavy exercise/lifting may cause you to bleed more. 
  • You can have sex when you feel ready, but be sure to use contraception—you can get pregnant immediately after an abortion!
  • Wait at least 4 to 6 weeks after your abortion before taking a pregnancy test. 
  • For information on contraception, you can download the free Euki app; contact your personal Abortion Support Team member or your local health department; or go to plannedparenthood.org to find the closest family planning clinic.
  • Las Libres only sends pills to people who are already pregnant.  To stock up for possible future need, go to Plan C to see what low-cost options exist for your state. To find out whether a provider offers pills in advance, click on the “More Information” button.

If you have questions or need help

  • Contact your personal Abortion Support Team member
     

  • Miscarriage and Abortion Hotline (M+A Hotline): (833) 246-2632 (8 am-11 pm, 7 days a week, in all U.S. time zones) They will respond within one hour. For more info: mahotline.org
     
  • ReproCare Healthline: (833) 226-7821 (9 am- 9 pm Pacific time; 10 am-10 pm Mountain; 11 am-11 pm Central; 12 am-12 pm Eastern, 7 days a week) For more info: abortionhotline.org

How to keep safe

If you go to a hospital or other healthcare facility, do not tell anyone that you took the pills. There is no way for anyone to know you took the pills. Tell them you think you are having a miscarriage. Miscarriages are common and occur naturally.
 

Your phone is your private property. You do not have to show your phone to anyone who does not have a search warrant from a court. 
 

Your digital footprint can be used against you if there is a search warrant from a court. To keep yourself safe:

  • Use the Signal app for communications—especially with your Support Team member, but also with anyone involved in your situation.

  • Use a VPN (TunnelBear VPN is free) and a secure browser (DuckDuckGo is free).
  • Password protect your phone and other devices, make sure not to share your passwords with anyone. 
  • It's important to erase any social media posts, emails and text messages related to abortion. We recommend erasing these within a few hours so that you don't forget.
  • Continuously clear your browsing history if it’s related to abortion; also your cookies and your cache.

 

If you have questions about your legal rights or need a lawyer, call Repro Legal Helpline (844) 868-2812 or search for reprolegalhelpline.org