Signs the abortion pill worked—and what to do if it didn’t
Wondering if your abortion pills (mifepristone and misoprostol) worked? Learn the signs to look for, when to test, and what to do if something feels off—from the trusted care team at Hey Jane.
Abortion pills (mifepristone and misoprostol) are a safe, effective way to end a pregnancy. After taking them, it’s normal to wonder if they worked. This guide explains what signs to look for, how to check, and what to do if something doesn’t feel right.
Hey Jane is the #1 most-trusted virtual clinic providing medication abortions. If you’re looking for safe, at-home abortion care with 24/7 clinical support, start intake here.
How effective are abortion pills?
Abortion pills are very effective when used the right way. Together, mifepristone and misoprostol work up to 98% of the time for pregnancies under 10 weeks.
What are signs that the abortion worked?
Every person is different, but here are common signs that the pills are working:
Symptom
Description
Bleeding and cramping
Heavy bleeding and strong cramping within a few hours after taking misoprostol are signs that your uterus is emptying.
Passing blood clots or tissue
It’s normal to pass blood clots or tissue during the process, which can range in size from small specks to golf ball-sized clots.
Bleeding gets lighter over time
It’s normal to bleed for a few days up to 2 weeks after a medication abortion, but it should get better as time goes on.
Pregnancy symptoms fade
Symptoms like nausea, breast tenderness, and fatigue should get better within a week, and usually go away completely within 2 weeks.
This table outlines common symptoms experienced after a medication abortion and what they may indicate.
If you notice most or all of these signs, it’s a good indication that the abortion worked.
How can you be sure it worked?
To be sure the abortion is complete, you can:
What to do
Timing
Follow-up ultrasound: You can get an in-person ultrasound (also called a sonogram) to check if the pregnancy has ended.
Tip: If you go too soon, it might look unclear. Some providers who don’t often do abortion care may read it wrong.
No sooner than 2 weeks after completing treatment (unless recommended by your provider)
Follow-up labwork*: A single blood test can’t always show if the abortion worked. But if you get one before and after treatment, your provider can compare your pregnancy hormone levels. A big drop usually means the abortion worked.
1 test the day you take mifepristone and another test 5 days later.
Monitor your pregnancy symptoms: If symptoms like nausea, breast tenderness, or fatigue go away, that’s a good sign the abortion worked.
1–2 weeks after taking the pills
Take an at-home pregnancy test: Testing too early can give a false positive because pregnancy hormones take time to leave your body.
Note: If you were very early in pregnancy (less than 5 weeks), your test may turn negative sooner.
4 weeks after taking the pills
This table outlines when and how to check if your medication abortion was successful.
*If you are a Hey Jane patient, we can help connect you to trusted clinics in your area.
If you're not sure the abortion worked or still feel pregnant, here's what to do.
Contact your provider: They can help you figure out next steps, which may include monitoring symptoms for a little longer, follow-up testing, or another dose of medication.
Watch for signs of incomplete abortion: Please seek medical attention if you experience bleeding that doesn’t slow down, ongoing severe cramps, or fever and chills.
When to seek medical attention
While serious complications from abortion pills are rare, call your provider right away—or go to the ER—if you experience:
At any time:
Symptom
What to do
Severe one-sided abdominal pain Pass out or faint
Go to the emergency department immediately
You soak more than 2 heavy flow pads an hour for more than 2 hours in a row Moderate to severe belly pain or cramps that don’t get better with pain medicine or a heating pad Weakness, nausea, or diarrhea lasting more than 24 hours
Hey Jane patients: Call our urgent line listed on page 2 of your treatment guide.
Non-Hey Jane patients: Contact your provider or go to the emergency department.
This table shows serious symptoms that could indicate a complication and explains when to seek immediate medical help.
24 hours or more after taking misoprostol:
Symptom
What to do
Moderate to severe cramping or bleeding is not getting better You have a fever of 101°F or higher (fever is common during the first 24 hours)—always check your temperature with a thermometer.
Go to the emergency department immediately
Your belly pain is getting worse You start to feel very ill (weakness, nausea/vomiting, or diarrhea) after the heavy cramping and bleeding is over
Hey Jane patients: Call our urgent line listed on page 2 of your treatment guide.
Non-Hey Jane patients: Contact your provider or go to the emergency department.
You have not had bleeding as heavy as a period** Weakness, nausea, or diarrhea lasting more than 24 hours
Hey Jane patients: Message us through the patient portal.
Non-Hey Jane patients: Contact your provider.
This table outlines when to reach out to a provider or seek emergency care based on post-treatment symptoms.
**It is common for bleeding to be lighter than a period for people that are earlier in their pregnancy (6 weeks or less). However, it may also be a sign that you need to take another dose of misoprostol to complete the abortion. Your provider can guide you through next steps.
1 week after taking the pills:
Symptom
What to do
Cramping or bleeding is not getting better You have a fever of 101°F or higher (fever is common during the first 24 hours) Your belly pain is getting worse
Hey Jane patients: Call our urgent line listed on page 2 of your treatment guide.
Non-Hey Jane patients: Contact your provider or go to the emergency department.
You do not feel that you passed the pregnancy Your pregnancy symptoms (such as nausea and breast tenderness/soreness) are not getting better
Hey Jane patients: Message us through the patient portal.
Non-Hey Jane patients: Contact your provider.
This table explains what to do if you're concerned your abortion may not have worked or if your symptoms are getting worse.
Paying attention to your body, monitoring your symptoms, and taking a follow-up pregnancy test 4 weeks after treatment can help you feel more confident in the outcome of your medication abortion. Most people don’t need extra treatment after taking abortion pills. But if something feels off, or you have questions, don’t wait to reach out. We're here for you.
Get safe abortion care at home: 24/7 urgent clinical hotline, plus chat support with your care team.
Abbi (she/her) is an Austin-based writer and editor with a passion for queer theory, sexuality, health, and culture. She received her master's degree with a concentration in LGBTQIA+ Sexual Health and Education Interventions from Washington University in St. Louis.
Published on:
July 14, 2025
Last updated:
July 14, 2025
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