Mifepristone and Misoprostol How to Take

In India, abortion has been legal since 1971. Still, there is a significant knowledge gap regarding how to have an abortion. There are two ways to have an abortion: one with abortion pills and the other using a surgical procedure. This article will focus on how to have an abortion with pills, namely mifepristone and misoprostol, while giving insights into their relevance for the Indian subcontinent. It talks about what these pills are, how to take them, their side effects, post-recovery care, and the names of the medicines and their manufacturers available in India. This guide will help you learn more about self-managing your medical abortion process.

Abortion with pills in India

The abortion pills used in India typically include mifepristone and misoprostol. In India, these two pills are often prescribed to terminate a pregnancy of up to 9 weeks,63 days. However, abortion pills can be taken later in the pregnancy – the HowToUseAbortionPill protocol for example, is intended for pregnancies up to 13 weeks.

The medicine used in medical abortion pills works by relaxing and opening the cervix (opening to the uterus) and causing the uterus to contract, which pushes out the pregnancy.

Misoprostol can be used as a stand-alone medicine, although the combination of mifepristone and misoprostol is recommended if available, as it’s slightly more effective. In India, the combination of mifepristone with misoprostol is more commonly used. Acquaint yourself with the abortion with pills process by researching as much as you can. You can start a chat on Whatsapp with our safe abortion chatbot for answers to any questions you may have about abortion or watch our educational video series on how to self-manage your abortion with pills. After this, plan a visit to your health care practitioner to get a prescription for these pills.

Where are abortion pills available?

You can purchase abortion pills from a pharmacy; however, you need a prescription from a healthcare provider to purchase them, as they are not sold over the counter in India.

How do you get started if you wish to abort through pills?

Confirm the pregnancy and gestation period. You can do this using our pregnancy calculator. As mentioned, the HowToUse protocol can be used for pregnancies less than 13 weeks. However, the gestation period for which abortion pills are usually prescribed in India is up to 9 weeks.
Understanding the Process in Detail: Gain a thorough understanding of the medical procedure, the potential side effects, and the post-care requirements.
In order to be prepared for the abortion, it can be useful to have some things on hand. This includes large maxi pads (not tampons), painkillers, a hot water bottle or heating pad, access to a toilet, light snacks, a friend or support person, and a comfortable bed or mattress.
Create a safety plan in case you need it for any possible emergency.

How do I take these pills?

The information below is only intended for pregnancies less than 13 weeks. Pregnancies that are 13 weeks or more may need a different approach. You can reach out to our sister page, safe2choose for information on abortion for pregnancies of 13 weeks or more.

Mifepristone and Misoprostol

If both mifepristone and misoprostol are being used, then mifepristone is taken first. The standard dosage is 200 milligrams (mgs), which is usually covered in one dose.
This tablet is taken orally, so keep a glass of water handy while consuming it.
Swallow one 200 mg mifepristone with water.
Wait 24-48 hours to take misoprostol. We suggest taking misoprostol sublingually (under your tongue). If taken sublingually, place four misoprostol tablets (usually four tablets of 200 mcg each) under the tongue to dissolve, then swallow everything that’s left of the pills with water after 30 minutes.
If you do not experience bleeding 24 hours after the first dose or are unsure if the abortion worked, place 4 more pills under your tongue and hold them for 30 minutes. After 30 minutes, drink some water and swallow everything that is left of the pills.

Misoprostol Only

Place four misoprostol pills (200mg each) under your tongue and wait 30 minutes for them to dissolve. After 30 minutes, drink some water and swallow everything left of the pills.
Wait 3 hours, and place another four pills under your tongue. Wait 30 minutes for them to dissolve.
Wait another 3 hours and repeat the process – placing another 4 misoprostol pills (200mcg) under your tongue and hold them there for 30 minutes until they dissolve.
You should begin bleeding and cramping while taking the pills. Make sure to take all 12 pills, even if you begin bleeding before you’ve taken all of them.

What happens after you take these pills?

Misoprostol mostly causes cramping and bleeding to empty the uterus. Taking painkillers right after taking the first round of misoprostol pills can help reduce pain. Aside from cramping and bleeding, you may also experience nausea, dizziness, diarrhea, chills, headaches, or a temporary rise in temperature after taking misoprostol. All of these are normal side effects of misoprostol and will most likely go away on their own. You may identify the pregnancy tissue when it passes. It can look like dark colored blood clots with thin membranes or a small sac surrounded by a white, fluffy layer. Depending on the age of the pregnancy, it can be smaller than your fingernail, or up to the size of your thumb. In an abortion between 10-13 weeks, it’s possible to see something that may be recognizable as the pregnancy or may look like tissue or a blood clot. This is normal and it should not alarm you. It is a sign that the abortion is proceeding as expected.

Abortions with pills are safe. However, like every medical procedure, it is important to recognize possible signs of complications, such as;

Bleeding that is so heavy that it soaks up 2 regular menstrual pads every hour for 2 hours in a row.
Severe abdominal pain that does not go away with pain medication or continues for 2-3 days after taking the pills.
A fever or other side effects that last more than 24 hours.
Abnormal vaginal discharge that is yellow, green, or smells bad.
You should seek immediate medical care if you experience any of the signs above.

Post-Recovery Period and Care

Avoid strenuous activities: We won’t lie, the process can be taxing on one’s body. Avoid lifting heavy weights or engaging in strenuous activities during and right after the abortion with pills.
Reach out for support: Having your partner, friends, or family for support and surrounding yourself with your loved ones could help ease some of the anxiety an abortion seeker may experience during the process.
Meal: Stay hydrated, eat nutritious and balanced meals and avoid drinking alcohol until you feel the abortion has been successful.
Vaginal Bleeding: Keep sanitary napkins handy when experiencing vaginal bleeding. Also monitor the duration of the bleeding, inform, and seek guidance from a health care practitioner if you suspect complications.
Monitor all the symptoms in the post-recovery period. This is a vital step, and reporting on these symptoms to your medical practitioner when concerned will help you deal with them. Additionally, if there are any complications, you will receive timely support.
Give yourself time. Allowing yourself to feel all the different emotions and giving yourself adequate time to heal will ensure that you are not only being hard on yourself but also helping in the recovery.
Effective Contraceptive Methods: Looking for a contraceptive method? Our friends at FindMyMethod can provide you with comprehensive information on the contraceptive methods available in India.

Available abortion pills in India

MTP kit by Cipla Medicine
Unwanted kit by Mankind Pharma Limited

Lastly, keep in mind that having an abortion is a perfectly natural and legitimate decision and that the ability to make decisions about one’s own body is a human right. Access to e-health platforms that offer comprehensive information, such as HowtoUseAbortionPill, is also desperately needed. These tools could help you plan your abortion procedure and offer assistance before you book a visit with a doctor. To sum up, be fully informed about an abortion with pills and if you decide to have an abortion, your decision is extremely normal and valid.