Medication abortion, often called the “abortion pill,” is a common and safe method used to end an early pregnancy. This process involves a combination regimen of two distinct medications taken in a specific sequence. The use of two different pills allows the body to first prepare for, and then complete, the process of expelling the pregnancy tissue. This method has become the most frequent choice for abortion in the United States, offering a non-surgical alternative for those who qualify based on gestational age.
Identifying the Two Medications
The two medications used in this regimen are mifepristone and misoprostol, each performing a separate and necessary function. The first drug taken is mifepristone, which works by blocking the action of progesterone. Progesterone is a hormone naturally produced by the body that is necessary to sustain a pregnancy. By inhibiting this hormone, mifepristone causes the uterine lining to break down and stops the pregnancy from progressing.
The second medication, misoprostol, is a synthetic prostaglandin, a substance that causes the uterus to contract. These contractions cause cramping and bleeding, ultimately leading to the emptying of the uterus. This two-drug approach is significantly more effective than using misoprostol alone.
The Physical Appearance of the Pills
The two medications used in the regimen look noticeably different from one another, which helps to distinguish the steps in the process. Mifepristone is typically a single tablet that is taken first. While the exact appearance can vary slightly depending on the manufacturer, it is often a larger pill, sometimes described as light yellow in color, and may be cylindrical or biconvex in shape.
The second component, misoprostol, comes as multiple smaller tablets, usually four pills, to achieve the required dosage of 800 micrograms. These tablets are commonly white in color, though a slight variation in shading is possible across different pharmaceutical companies. Misoprostol pills may be round, or they can be hexagonal, meaning they have six sides.
These smaller tablets often feature specific markings, such as a letter and a four-digit number, or a score line to indicate that the tablet can be broken. Both medications are typically provided in sealed packaging, such as blister packs, to protect their chemical integrity. The distinct size, shape, and color of the two types of tablets help the user correctly identify which pill to take at each stage of the medical process.
The Administration Schedule and Timing
The medication abortion process is structured around a specific sequence and timing between the two medications to maximize effectiveness. The first step involves taking the single mifepristone tablet orally, swallowing it whole with water. This pill begins the process by blocking progesterone and generally causes no immediate physical sensation or side effects that would interrupt normal daily activity.
The misoprostol tablets are taken later, typically between 24 and 48 hours after the mifepristone. This waiting period allows the mifepristone to fully prepare the uterine environment before the contractions begin. Taking the misoprostol dose too early or too late can reduce the overall success rate of the procedure.
The four misoprostol tablets are not swallowed immediately but are usually administered by placing them in the mouth, either between the cheek and gum (buccal administration) or under the tongue (sublingual). The user holds the tablets in place for about 30 minutes, allowing the medication to be absorbed through the mucous membranes. After this time, any remaining fragments of the tablets can be swallowed with water.
Some protocols allow for the misoprostol tablets to be placed vaginally, which can sometimes reduce certain side effects like nausea. Within a few hours of taking the misoprostol, the cramping and bleeding will begin, as the medication stimulates the uterus to expel the pregnancy. The expulsion of the pregnancy usually occurs within a few hours to a day, but bleeding and spotting can continue for several weeks afterward.