Medication Abortion

Last reviewed: 10/10/2024 

Overview

Medication Abortion is a method that uses medication to induce the termination of pregnancy. 

The appropriate pregnancy termination method depends on the number of weeks you have been pregnant, existing medical conditions, etc. To learn about other pregnancy termination options, please read our guide. Note that procedural abortions are not provided at Columbia Health but we can refer you to another nearby provider. 

If you are pregnant and are considering terminating your pregnancy:

When you start the Alice! Health Promotion intake form, you'll be prompted to log-in with your UNI and password. This is to ensure confidentiality and that you're a student enrolled at the University.
 
If you have concerns about sharing your UNI or additional questions, come to Health Education drop-in hours or call our office at 212-854-5453 during business hours.

If it is clinically appropriate for you to proceed with a medication abortion and you would like to complete it with Medical Services, you will be scheduled for an in-person appointment with a provider on the Medical Abortion team. If this method is not appropriate for you, the nurse will discuss your options and refer you to off-campus resources. 

What happens during a medication abortion 

During the in-person visit at Medical Services, your provider will give you a dose of mifepristone, which is the drug that starts the pregnancy termination process. They will discuss what to expect and give you the follow-up medication, misoprostol, which you must ingest at a specific time.  

Your provider will give you after care materials that include: 

  1. Explicit instructions about how and when to take the misoprostol 

  1. Important reminders about self-care, managing side effects, and getting help when needed 

  1. Information about the medications 

They will also schedule your remote follow-up visit for one week after the in-person visit. 

Eligibility 

Students and spouse/domestic partner dependents on the Columbia Plan who have (1) been screened as being clinically appropriate to proceed and (2) paid the full-time Columbia Health and Related Services fee can access this service at no additional cost. 

How to Schedule 

Call 212-854-7426 and ask to speak with a nurse on the Medical Abortion team.  

Questions About Options?

Schedule a visit with Alice! Health Promotion or call Medical Services at 212-854-7426 and ask to speak with the clinical team about your options.

Frequently Asked Questions

These are discussed in detail at your consultation appointment. In brief, procedural abortions involve instruments and suction placed into your vagina and uterus, so there is a small risk of cervical injury or uterine perforation that could require further care, including possibly surgery. There is also a higher risk of infection with surgical abortion, although antibiotics are given to minimize this risk. 
 
Medication abortions may be less effective, especially later in pregnancy. Also, with medication abortions, the abortion process occurs at home, rather than in the clinic setting, and the bleeding and cramping may be more of a prolonged process than with the procedure. 

The length of time from when you take the first pill until you finish passing the pregnancy is usually between 24-48 hours and will be affected by how you are directed to use the medications.

You’ll have lots of cramping and bleeding on the day the pregnancy comes out at home, and you may expect to continue to feel tired for 1 or 2 days after. Many people can go back to work and school, drive, walk, and do most other usual activities the next day if they feel up to it. It is not recommended that you do hard work or heavy exercise for several days.

Expected side effects of medication abortion include abdominal/pelvic cramping and aching and heavy vaginal bleeding with large clots. Potential risks of medication abortion commonly include digestive system discomfort (nausea, vomiting, diarrhea, abdominal cramping) and fatigue. 
 
Less common risks include heavy, prolonged vaginal bleeding and/or blood clots in the uterus, infection, or an allergic reaction to one of the medications. It is also possible the procedure will not work, which may result in needing a surgical abortion to complete the process. 
 
If the medication abortion does not work and you decide to continue the pregnancy after taking the medication used in medication abortion, the pregnancy is at higher risk for major complications. 

Medication abortion has not been shown to affect future pregnancies, unless rare and serious complications develop.

Not all individuals qualify for medication abortion, even if they are early in pregnancy; reasons may include having an intrauterine device (IUD) in place, having a suspected pregnancy outside the uterus (ectopic pregnancy), or having certain medical conditions, including those which increase the risk of bleeding.

How you feel during and after a medication abortion varies from person to person. Cramping and bleeding for several hours are an expected part of the procedure -- like a heavy, crampy period -- and many people manage well with over-the-counter pain medications. You can work with your health care provider to discuss what to expect in terms of pain and management strategies.

This will depend on the medications used. For the most common regimen, first, you take a pill called mifepristone. This medicine stops the pregnancy from growing. The second medicine is called misoprostol. This medicine causes cramping and bleeding to empty your uterus.

You can start a new birth control method immediately after having a medication abortion. You can get pregnant very quickly after your abortion, so it’s a good idea to talk with your medical provider about birth control options before or at your abortion appointment.

It’s normal to bleed and have some spotting for several weeks after your abortion. Abortion starts a new menstrual cycle, so your period will generally go back to your baseline normal 4-8 weeks after your abortion.