What If the Abortion Pill Does Not Work?

The abortion pill is 93 to 98% effective at ending a pregnancy within the first 10 weeks. This means that for the vast majority of patients, the two-pill process works completely without any additional treatment needed.

Effectiveness is highest when the abortion pill is used earlier in pregnancy. At 7 weeks or less, the success rate is approximately 98%. Between 7 and 9 weeks, it is about 95 to 97%. Between 9 and 10 weeks, the rate is around 93 to 95%. The provider at The Center for Women performs an ultrasound at your appointment to confirm how far along you are.

These are strong success rates compared to most medical treatments. However, no medication works 100% of the time. Understanding what happens in the rare cases where the abortion pill does not fully work can help you feel prepared.

When the abortion pill does not fully work, it usually means one of two things: an ongoing pregnancy (the pregnancy is still developing) or an incomplete abortion (some pregnancy tissue remains in the uterus, but the pregnancy is no longer developing).

An ongoing pregnancy after taking both pills is rare, occurring in about 2 to 5% of cases. An incomplete abortion, where most of the pregnancy has passed but some tissue remains, is somewhat more common. In many cases of incomplete abortion, the remaining tissue passes on its own over the following days.

Neither situation is an emergency in most cases, but both require follow-up care. This is exactly why The Center for Women includes a follow-up visit as part of your care.

In rare cases, the abortion pill may not work because the pregnancy is located outside the uterus — known as an ectopic pregnancy. If the pregnancy has not been confirmed to be in the uterus by ultrasound, this possibility must be considered. An ectopic pregnancy is a life-threatening emergency that cannot be treated with the abortion pill. Symptoms include severe pain on one side of the lower abdomen, shoulder pain, dizziness, or fainting. If you experience these symptoms, go to your nearest emergency room immediately.

The follow-up visit at The Center for Women is how you confirm the abortion is complete. The provider checks to make sure all pregnancy tissue has passed and your body is recovering normally. This visit is included in the $380 cost of your appointment.

Between your appointment and your follow-up, there are signs that suggest the process is working as expected. Most patients experience cramping and heavy bleeding within 1 to 4 hours of taking misoprostol. Bleeding heavier than a normal period, along with passing blood clots, is normal. After the heaviest bleeding, you may have lighter bleeding or spotting for up to 2 weeks.

Signs that you should call the clinic include: no bleeding at all within 24 hours of taking misoprostol, very light bleeding with no cramping, or continued symptoms of pregnancy (such as nausea and breast tenderness) that do not decrease over the following days. If you notice any of these, call The Center for Women at (708) 450-4545.

If the follow-up visit shows that some pregnancy tissue remains in the uterus, the provider will discuss your options. In many cases, the remaining tissue will pass on its own with additional time. The provider may recommend a watchful waiting approach with another follow-up visit.

If the tissue does not pass on its own, or if you prefer not to wait, the provider may prescribe an additional dose of misoprostol. This second dose helps the uterus pass the remaining tissue. This is a common and straightforward step.

In rare cases where medication alone is not enough, a brief procedure called aspiration may be recommended. The Center for Women does not perform surgical procedures, so the provider would refer you to a facility that does. This referral would be handled for you so you know exactly where to go and what to expect.

An ongoing pregnancy after taking both mifepristone and misoprostol is uncommon. When it does happen, continuing the pregnancy is not recommended because mifepristone can affect fetal development. The provider will discuss your options clearly.

Options for an ongoing pregnancy include taking an additional dose of misoprostol or having an aspiration procedure. The provider will explain both options and help you decide what is right for your situation. If an aspiration is needed, The Center for Women will provide a referral to a trusted facility.

The important thing to know is that this situation is identified at your follow-up visit. You will not be left without a clear path forward.

No. The follow-up visit is included in the $380 cost of your appointment at The Center for Women. This price covers your initial visit, ultrasound, both medications (mifepristone and misoprostol), and your follow-up appointment. There is no additional charge for the follow-up.

If the provider determines that you need a second dose of misoprostol, discuss the cost at that time. The Center for Women will be upfront about any costs before you agree to any additional treatment.

Call The Center for Women at (708) 450-4545 to schedule your appointment. Same-day, evening, and weekend appointments are available. The provider will perform an ultrasound to confirm your gestational age and review your health history before prescribing the abortion pill.

The Center for Women is located at 10215 W. Roosevelt Rd. #101, Westchester, IL 60154. The $380 cost includes your appointment, ultrasound, medications, and follow-up visit. Knowing that follow-up care is built into your visit can give you confidence that you will be supported throughout the entire process.