Abortion in the United States happens through two main routes: medication (pills) or an in-clinic procedure. Which option is available to you depends primarily on how far along the pregnancy is, your medical history, and where you live. Both are safe, with only about 2% of patients experiencing any complication, and most of those are minor and treatable with antibiotics or a follow-up visit. The risk of death from childbirth is roughly 14 times higher than from abortion.
Medication Abortion (Up to 10 Weeks)
Medication abortion uses two pills taken in sequence. The first blocks the hormone progesterone, which the pregnancy needs to continue. The second, taken 24 to 48 hours later, causes the uterus to contract and empty. The FDA approves this method through 10 weeks of pregnancy, counted from the first day of your last period. It can be prescribed in person or through a telehealth visit, and the pills can be mailed to you in many states.
The experience is similar to a heavy, crampy period. Most people pass the pregnancy within a few hours of taking the second pill. You’ll want to be somewhere comfortable with access to a bathroom, heating pad, and pain relief like ibuprofen. Bleeding and cramping are heaviest in the first few hours but can continue on and off for up to four weeks.
In 2023, the median out-of-pocket cost for medication abortion at a clinic was $563. Virtual-only telehealth clinics charged a median of $150. Online pharmacies listed on the resource site Plan C range from $25 for pills by mail without a consultation to around $150 with one.
In-Clinic Procedures
If the pregnancy is beyond 10 weeks, or if you prefer a faster, more controlled process, an in-clinic procedure is the other option. In the first trimester, this is a suction procedure that takes about 5 to 10 minutes. You’ll typically receive local numbing, sedation, or both. The median self-pay cost in 2023 was $650 for a first-trimester procedure.
From 14 weeks onward, the procedure involves both instruments and suction, and takes about 10 to 20 minutes. Up to 18 weeks, this may be done under sedation or general anesthesia. After 18 weeks, general anesthesia is standard. You’ll need cervical preparation either the day of or the day before surgery. Second-trimester costs rise, with a median self-pay of around $1,000.
What Happens Before the Appointment
Before any abortion, a provider will confirm that the pregnancy is in the uterus and estimate how far along it is. This matters because an ectopic pregnancy (one growing outside the uterus, usually in a fallopian tube) cannot be treated with abortion pills and requires different medical care. If you have risk factors for ectopic pregnancy, such as a previous ectopic, an IUD in place, or prior fallopian tube surgery, expect an ultrasound or physical exam.
Medication abortion is not appropriate for everyone. People with severe uncontrolled asthma, chronic adrenal failure, or a known or suspected ectopic pregnancy are not candidates. Your provider will ask about these conditions and review your medical history. If you have Rh-negative blood, your provider may offer a shot that prevents your immune system from producing antibodies that could affect a future pregnancy. This is a quick injection, ideally given within 72 hours of the abortion.
Recovery and What to Watch For
Most people return to normal activities the next day. You can shower, but avoid baths, swimming, and submerging in water for two weeks. During that same period, avoid vaginal intercourse and don’t insert anything into the vagina (with the exception of a NuvaRing if that’s your birth control). If you received IV sedation, don’t drive for 24 hours.
Bleeding can last up to four weeks, though it’s often intermittent. Some people experience a burst of heavier bleeding and cramps four to six days after the procedure. This is normal. What isn’t normal: soaking through one pad per hour for three consecutive hours, a fever over 100°F or chills, or severe abdominal pain that doesn’t respond to ibuprofen or acetaminophen. These symptoms warrant a call to your provider.
Getting Abortion Pills by Mail
Telehealth has become a major access point. By the end of 2024, over one in seven abortions in the U.S. were medication abortions where pills were mailed from providers in states with legal protections to patients elsewhere, including in states with bans or heavy restrictions. Eight states currently have “shield laws” that protect providers from prosecution by other states, as long as the provider is licensed and located in the shield-law state.
This area of law is actively contested. Texas sued a New York-based physician in 2024 for mailing pills into the state, and Louisiana indicted the same doctor. So far, New York’s shield law has blocked enforcement of both actions. The legal landscape shifts frequently, so checking current state-specific resources before ordering is important. Organizations like Plan C maintain updated information on where and how to access pills by mail.
How to Find a Legitimate Provider
Not every facility advertising pregnancy services actually provides abortion care. Crisis pregnancy centers (CPCs) are organizations designed to discourage abortion. They often advertise free ultrasounds and a full range of reproductive services, but they do not perform abortions, provide referrals, or prescribe contraception. Some are not licensed medical facilities, which means they aren’t required to keep your information private. They’re sometimes located deliberately near actual abortion clinics.
Before booking an appointment, ask directly: Does this facility perform abortions or provide referrals? Is it a licensed medical clinic? Will you see a licensed provider? If a facility gives vague answers, pushes to delay your appointment, or won’t discuss costs or insurance, look elsewhere. Timing matters in abortion care, and delays can push you past gestational limits or increase cost and complexity. The National Abortion Federation hotline (1-800-772-9100) and ineedana.com are reliable starting points for finding verified clinics and financial assistance.
Costs and Financial Help
The price gap between telehealth and in-person care is significant. A virtual clinic consultation with pills by mail runs roughly $150, while in-person medication abortion at a clinic averages $563. Procedural abortions cost more, and the price climbs with gestational age. Insurance coverage varies widely by state and plan. Medicaid covers abortion in some states but not others.
Abortion funds exist in nearly every state and can help cover the cost of the procedure, travel, lodging, and childcare. The National Abortion Federation hotline connects callers with financial assistance. Many clinics also offer sliding-scale fees. If cost is a barrier, calling the clinic directly and asking about reduced rates or fund referrals is a practical first step.