The medication abortion process uses two different medications, mifepristone and misoprostol, taken in sequence, typically 24 to 48 hours apart. This two-step method is highly effective and does not require fasting. The first pill, mifepristone, works by blocking the hormone progesterone. The second medication, misoprostol, causes the uterus to contract, leading to cramping and bleeding. Because the medications are taken separately, the guidance for eating is also divided based on which pill is being taken.
Eating Guidance with Mifepristone
You do not need to restrict your diet before or after taking mifepristone, the first medication. You can eat normally before swallowing this tablet. Eating a normal meal shortly beforehand may help prevent an upset stomach.
Healthcare providers recommend avoiding heavy, greasy, or spicy foods, especially if you are prone to nausea. If you experience vomiting within the first 30 minutes of taking mifepristone, contact your provider, as the medication may not have been fully absorbed. Otherwise, you can continue your daily routine and normal diet until it is time to take the second medication.
Eating Guidance During Misoprostol Treatment
The second medication, misoprostol, is responsible for the physical process of the abortion and is the primary cause of gastrointestinal side effects like nausea, vomiting, and diarrhea. If you are taking misoprostol orally, dissolving the tablets between your cheek and gum for 30 minutes, you should not eat or drink anything during this period. Once the tablets are dissolved and swallowed with water, you may eat and drink normally, but a light diet is strongly advised.
To reduce the risk of gastrointestinal distress, stick to light, easily digestible foods that help settle the stomach. Avoid foods that are high in fat, spicy, or difficult to digest, as these can exacerbate nausea and diarrhea.
Recommended Light Foods
- Crackers
- Toast
- Rice
- Bananas
- Broth
Limit or avoid common stomach irritants like dairy products, excessive caffeine, and alcohol during the misoprostol treatment phase. Side effects typically begin within a few hours of taking misoprostol, and the most intense period usually lasts for four to six hours. Planning light and simple meals during this window can contribute to your comfort.
Addressing Nausea and Dehydration
Severe nausea and vomiting are common side effects of misoprostol, which can prevent keeping down solid food. If you experience persistent vomiting, focus on maintaining hydration and safety. Take any prescribed anti-nausea medication as directed, ideally before or at the time of the misoprostol dosage, to preemptively manage these symptoms.
If vomiting is severe and frequent, focus on sipping small amounts of clear liquids. Hydration is critical, as vomiting and diarrhea rapidly deplete fluid stores and can lead to dehydration. Water, clear broths, and electrolyte solutions are the best choices for replacing lost fluids and salts.
Signs of dehydration that warrant a call to your healthcare provider include feeling dizzy, lightheaded, or very thirsty, and a noticeable decrease in the frequency of urination. If you cannot keep any liquids down for several hours, or if you vomit more than two or three times, contact your clinic immediately for guidance. Most symptoms, including severe nausea, will begin to resolve within 24 hours of taking misoprostol.