What to expect

A clear, honest guide to what happens before, during, and after medication abortion.

Day 1

Step 1, the process begins

  • You take the first tablet as directed.
  • Most people have no symptoms on Day 1.
  • Light spotting may begin
  • The tablet blocks the hormone needed to maintain the pregnancy.
  • Continue your usual activities.

Days 2–3

Step 2, the main event

  • You take the next tablets 24–48 hours after Step 1.
  • Cramping and bleeding usually begin within 1–4 hours.
  • Cramping can be strong, take prescribed pain relief proactively.
  • Heavy bleeding with clots is expected and normal.
  • Have pads, a heat pack, and pain relief ready.
  • Nausea, chills, and mild temperature may occur, this is expected.

Days 3–14

Gradual completion

  • Bleeding gradually reduces over 5-10 days.
  • Light spotting can continue for up to 4-6 weeks.
  • Most cramping resolves within 24–48 hours.
  • Pregnancy symptoms (nausea, breast tenderness) should begin to ease.
  • Continue to rest and take care of yourself.
  • Contact us if you have any concerns.

Follow-up

Thriving forward

  • Complete your LSUP (provided urine test) 14 days after step 2.
  • Follow-up appointment is scheduled 14–21 days after step 2.
  • Physical and emotional assessment.
  • Discuss ongoing contraception needs.
  • Discuss return of menstrual period.
  • Continue to rest and take care of yourself.
  • Contact us if you have any concerns.

About the medication

A medical abortion uses medication to terminate pregnancy under 9 weeks gestation.

Step 1 works by blocking the hormone progesterone, which is essential for maintaining a pregnancy. By doing so, Step 1 disrupts communication between your body and the pregnancy, preparing the body to terminate the pregnancy.

Step 2 is taken 24–48 hours after taking Step 1. Step 2 causes uterine contractions and cervical dilation, which help the body expel the pregnancy and pregnancy tissue through uterine bleeding.

You will also be prescribed other medication to make the process as comfortable as possible.

You will be prescribed:

  • Abortion medication
  • Prescription anti-nausea medication
  • Two different types of prescription pain relief

Bleeding, what to expect

Heavy bleeding with clots is expected and normal in the first 24–48 hours after Step 2.

  • Light-to-moderate bleeding for 1–2 weeks is typical.
  • Spotting may continue for up to 4-6 weeks.
  • Passing moderate sized blood clots is a normal part of the abortion process.

Pain management

Cramping can be intense, particularly in the first few hours after Step 2. This is normal and manageable.

  • Take prescribed pain relief proactively, before cramping begins.
  • A hot water bottle or heat pack on your abdomen can help.
  • Ibuprofen is generally recommended alongside any prescribed medication.
  • Rest as much as possible on Day 2–3.

Normal symptoms

  • Heavy bleeding with clots
  • Strong cramping
  • Nausea or vomiting
  • Diarrhoea
  • Chills and shivering
  • Low-grade fever (under 38°C) for under 24 hours
  • Fatigue
  • Emotional feelings, relief, sadness, mixed emotions are all valid

Urgent symptoms, seek care immediately

  • Soaking 4 maxi pads in 2 hours
  • Soaking 10 maxi pads in 10 hours
  • Passing clots the size of a tennis ball or bigger
  • Severe abdominal pain lasting 2 or more hours despite taking simple pain relief
  • Signs of infection: fever over 38°C lasting more than 24 hours
  • Shortness of breath, chest pain, shoulder tip pain, feeling faint
  • Feeling unsafe

Call 000 immediately or go to your nearest emergency department.

Book Consult 1