Taking the Misoprostol

Step 3:  

Take Misoprostol (4 pills of 200mcg each)

There are THREE possible ways to take MISOPROSTOL: 

1. Under the tongue- insert all 4 pills under the tongue and wait 30 min for them to dissolve, then swallow the rest

2. In the cheeks- insert the 4 pills between the cheeks and the teeth, wait 30 min for them to dissolve, then swallow the rest

3. Deep in the vagina, at the cervix– with clean hands, insert the 4 pills deep into the vagina, as close as possible to the cervix. Lay down for 30 minutes. See the next lesson for more information about Misoprostol.

Which administration route should I use? 

• if you live in a country where abortion is illegal or could be criminalized, put under your tongue, or between your cheeks and gums. Misoprostol can be detected when put into the vaginal canal–up to days later. However, misoprostol taken in the mouth cannot be detected at all up to five minutes after absorption into the mouth. 
• The vaginal route can be more direct if misoprostol is inserted deep enough into the vagina and at the cervix. There can be fewer side effects of the misoprostol because it doesn’t need to travel through the whole body to reach your cervix. Sometimes you may need a repeat dose. 
• It is wise to have a second dose of 4 misoprostol tablets with you in case you need a repeat dose for any reason. 
• When in doubt, choose the oral route. There is less chance for human error. 

What happens after I take the misoprostol? 

The misoprostol will stay under your tongue, between your cheeks, or in your vagina for 30 minutes. In this time it will dissolve into the mucus membrane of your cheeks or vaginal wall and into the bloodstream. From here, it will start to work. After 30 minutes have passed, or after the pills are totally dissolved, you can swallow the remnants. 

Many women vomit after taking misoprostol, and the misoprostol should still work as long as it’s been dissolved for about 30 (or one hour since you inserted them into your mouth or vagina).

It is normal to feel intense chills, and this can be remedied by a heating pad or hot water bottle. This is the most intense part of taking misoprostol–is that you will feel very cold and potentially sick to your stomach. This is normal. The chills will diminish if you use a source of heat and stay cozy under your covers. 

When will I start bleeding? 

Be prepared for your bleeding to start 1 hour after taking the misoprostol or up to 8 hours. Everyone’s body is different, and every abortion is different. Anticipate any outcome and you will be the most prepared. 

The amount and type of bleeding may differ for each person. You may pass blot clots, or not, but if you do pass clots, a rule of thumb–the clots should be no larger than a lemon. 

After you pass the pregnancy your bleeding should reduce. Bleeding can last up to two weeks. Normally it becomes very light but can start up again. and be quite heavy for a few days. If this happens, there is likely still tissue retained in the uterus, and your body is trying to expel it. If the bleeding continues or is accompanied by a strong unpleasant odor, you should seek medical assistance immediately.