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RU486: How Does the Abortion Pill Work?

This is the second in a series of four articles with information about RU486, the abortion pill. (Read the first article.)

One of the many questions you may have when looking into a medication abortion is “how does the abortion pill work?” It’s easy to feel rushed during an unexpected pregnancy decision. However, when looking into any type of medical process, it is always important to first get all of the information. Learning more about how the abortion pill works will help you take the next steps in your decision-making process.

Avenue Women’s Center provides the information and services you need when looking into a medication abortion. We understand each woman’s situation is unique. During a confidential consultation, we’ll talk through your options – including the abortion pill, and address your individual questions. Call, chat, email, or text for an appointment at one of our six Chicagoland locations. 

Understanding How the Abortion Pill Works

If you want to know more about how the abortion pill works, we should first explain that it is not the same thing as the “morning after pill.” While the morning after pill can be used in the days right after intercourse, the abortion pill is FDA-approved several weeks into an established pregnancy.

The medication abortion process actually uses two different medications to end a pregnancy. These medications are mifepristone, sometimes called “mifeprex,” and misoprostol. Two – or perhaps three – visits to your medical provider, and close observation throughout the process, are often required. Before the medication abortion, you will typically need to have laboratory tests and a physical exam, including an ultrasound.


The first medication, mifepristone, is given at the clinic. It’s possible you will be asked to take an antibiotic at this time as well. The mifepristone ends the pregnancy by blocking the hormone progesterone. Without this hormone, the lining of the uterus breaks down, and the pregnancy ends.


The second medication, misoprostol, is typically taken 24-48 hours after the first. It brings on uterine contractions which will empty the uterus and expel the pregnancy. This medication may be taken at home. You should talk with your medical provider about when and where to take this medication. Often, it will cause cramps and bleeding. The length of time for the cramping and bleeding can vary from one woman to another. For most women, it can be from a few hours to a few days.

Follow-Up Exam

Within 1-2 weeks after taking the second medication, a follow-up appointment may be scheduled with your medical provider. This is important to make sure that your abortion is complete. If you are still pregnant, you will need to talk with your healthcare provider as you may need to have an in-clinic surgical abortion to end the pregnancy.

Next Steps When Considering the Abortion Pill

Prior to having a medical abortion, it can be helpful to complete an ultrasound exam. The ultrasound will tell you how far along you are, letting you know if you are eligible for the abortion pill. Also, it can alert you to early pregnancy risks. Miscarriage occurs naturally in approximately 1 out of every 5 to 6 pregnancies. And if your pregnancy is not viable, the cost of an abortion pill may be avoided.

Learning more about how the abortion pill works is an important step in a pregnancy decision. Avenue Women’s Center is here to help. Receive more information about your pregnancy through a free limited ultrasound exam. During your appointment, you can learn more about abortion procedures, risks, and alternatives. Make an informed decision by scheduling today

The information provided here is general in nature.  It is not a substitute for a consultation with a medical professional. Before any medical procedure, it is imperative that you discuss your personal medical history, risks, and concerns with your doctor. If you have questions during or after a procedure, your doctor should be immediately contacted. Avenue Women’s Center is not an emergency center.  If you are experiencing severe symptoms, such as bleeding and/or pain, seek immediate medical attention.  Contact your physician, go to an emergency room, or call 911.