Medication Abortion, RU-486, the Abortion Pill, Medical Abortion, Chemical Abortion[1]

You may have heard of the abortion pill referred to by different names. Even though the terms may be different, the medication is the same. The Abortion Pill is not the same as emergency contraception (i.e. Morning After Pill, Plan B, Ella). Medical abortion is a procedure that uses medication to end a known pregnancy.

Before a medication abortion, you should meet with your doctor to discuss terminating your pregnancy. You should be given a physical examination to determine whether you’re a candidate for RU-486, and you should be given an ultrasound to ensure that you really are pregnant and within the gestational dating that RU-486 can be prescribed. Unfortunately, women have been given the abortion pill when they were not even pregnant.[1]

Ending your pregnancy through the abortion pill is a three-step process.

First, you will be given a drug that will cause the death of your embryo or fetus, thus ending your pregnancy.

Note: Some women change their mind and decide they do not want to continue the medication abortion at this point. Contact us and we will connect you with a network of caring medical professionals who can help reverse the effects of this medication in some cases.

Second, you will be given another drug that will cause you to expel the embryo or fetus from your body. Women are usually not in their doctor’s office when they feel the effects of this drug. Some women have experienced nausea, weakness, fever/chills, vomiting, headache, diarrhea, and dizziness.[2]

Third, about seven to fourteen days after the first drug, you should follow up with your doctor to ensure all the contents of your uterus have been expelled. If there is anything left over, it may require a surgical abortion in some cases. This is a potentially serious condition, and this follow-up appointment is very important.

First-Trimester Aspiration Abortion (up to twelve or thirteen weeks of pregnancy)[3]

Depending on how far along you are in the first trimester, this procedure may be done without dilation or anesthesia. If you are further along in your pregnancy, the abortion provider may begin by using local anesthesia to numb the cervix.

After it is numbed, the cervix must be stretched open. The abortion provider inserts the dilator through the vagina and into the cervix. Once it has established a clear pathway, the abortion provider will continue by inserting progressively larger dilators into the cervix.

When the cervix has been stretched wide enough, the abortion provider suctions out the contents of the uterus. After the embryo or fetus and the pregnancy matter have been removed, the abortion provider will inspect the cervix and other internal organs.

To ensure the procedure is complete, some providers will use sharp curettage followed by final suctioning to ensure that nothing has been leftover inside the uterus.

Afterward, you most likely will be taken to a recovery room to recuperate. The recovery time after the procedure varies. Physical complications resulting from the abortion may manifest immediately or sometime later.

doctor in surgery

Dilation & Evacuation (D&E) Second or Third Trimester (roughly thirteen weeks of pregnancy and onward)[4]


The abortion provider begins by opening the cervix. At this stage in pregnancy, the cervix needs to be opened wider than in a first-trimester abortion. To do so, the abortion provider will use dilators. For pregnancies that are early in the second trimester, dilation can take several hours or be overnight; dilation may take one to two days for pregnancies that are further along in the second trimester. Different methods exist to dilate the cervix, and the method used depends on many factors.

D&E Procedure

The abortion provider will begin by removing the dilators and then may use an ultrasound to locate the fetus and pregnancy matter. If it is early in the second trimester, suction aspiration may be enough to remove the pregnancy without the use of forceps. This is similar to a vacuum aspiration abortion procedure.

After about sixteen weeks gestation, forceps are usually needed to complete the procedure. The abortion provider inserts forceps into the uterus, opens them, and begins to pull the fetus apart and out using a rotating motion. After the fetus and the contents in the uterus have been evacuated, the provider will check to make sure nothing internally has been punctured during the procedure and that the fetus, as well as the pregnancy matter, have been removed.

Fetal Demise

If the fetus has reached an age where he or she could live independently of the mother, the abortion provider may choose to inject the fetus with chemicals. Depending on the drug used, it is injected either into the amniotic sac or into the fetus’s heart or umbilical cord. The abortion provider may use ultrasound to direct the needle as it is being inserted. After the fetus has died, the provider may perform a D&E procedure to ensure nothing has been left inside the uterus.

Intact D&E

The more passes the forceps must make into the uterus, the more potential there is for harm. In cases when the cervix has been stretched open wide enough, it is desirable for the fetus to be removed from the uterus intact. The abortion provider will insert dilators (usually laminaria) about two days in advance. Often, the skull of the fetus is too big to pass through the cervical canal and must be crushed so it can be removed. The abortion provider may accomplish this through the use of forceps or by making an opening at the base of the skull through which the contents can be suctioned out. If complications arise, the abortion provider may pierce the skull with a sharp instrument and collapse it using forceps or suction. After this, the abortion provider can remove the fetus from the uterus otherwise intact.

Many women who choose a late-term abortion do so because the fetus has been diagnosed with an abnormality. If this is the case, you have help, hope, and options. Call us so we can talk to you about all of your options.

If you are thinking about abortion, you are not alone. There are a number of options available to you that do not include abortion. As with any medical procedure, it’s important to understand what abortion entails: side effects, possible risks, complications and alternatives. If you are ready to talk to someone about your situation, call us and we can provide you with confidential help.

Asian doctor woman encourage young woman patient by holding hand

We offer accurate information about all your pregnancy options; however, we do not offer or refer for abortion services. The information presented on this website is intended for general education purposes only and should not be relied upon as a substitute for professional and/or medical advice.

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[1] Medical Abortion. Mayo Clinic Website: Published May 14, 2020. Retrieved June 5, 2020.
[1] Controversial Oklahoma City abortion doctor stripped of medical license. Oklahoma News 4 Website: Published January 14, 2016. Retrieved June 5, 2020.
[2] Clinical Trials Experience, Danco Laboratories, last modified March 2016,
[3] Abortion (Termination of Pregnancy). Harvard University Website: Published January 2019. Retrieved June 5, 2020.
[4] Dilation and curettage. Mayo Clinic Website: Retrieved June 5, 2020. Questions and answers on late-term abortion. Charlotte Lozier Institute Website: Published February 24, 2020. Retrieved June 5, 2020.