Sexual and Reproductive Health after an Abortion with Pills: What to Know

Whether you’ve had a medical abortion with Mifepristone and Misoprostol, or Misoprostol Alone, taking care of your sexual and reproductive health afterward is essential. There is no 'one size fits all' recovery process, so it’s important to listen to your body, take things at your own pace, and know what to expect in the days and weeks ahead.

This guide answers common questions about recovery, contraception, bleeding, sex, and when to seek help—so you can feel informed and supported as you move forward through your abortion process.

What to Expect Physically After an Abortion with Pills

After a medical abortion with pills, your body will go through a process of cramping and bleeding. This is normal and means the abortion is working.

• After taking Mifepristone: You may feel fine and be able to go about your day physically, but it's also equally important to validate and reflect about your emotions and spiritual needs.

• After taking Misoprostol: Expected side effects are: light fever, chills, diarrhea.  Cramping and bleeding are more intense, usually within the first 12 hours. Many people choose to rest during this time and most symptoms ease within 48 hours.

Bleeding can continue for up to two weeks, sometimes more. It’s also normal to pass clots and see pregnancy tissue during this time. If the abortion is successful, your body will expel the contents of the uterus naturally, and no further treatment is needed. In rare cases, some tissue may remain. In this case, a Doula or healthcare provider may suggest a clinical follow-up, but keep in mind that a surgical procedure is only necessary if there’s a medical reason. If removal is required, the safest method is manual vacuum aspiration (MVA). Dilation and curettage (D&C) should only be used if MVA isn’t available.

What to Expect Emotionally After an Abortion with Pills

Everyone’s emotional experience after an abortion is different—and all feelings are valid.

You may feel relief, sadness, empowerment, guilt, a sense of grief, or a mix of emotions that change over time. There’s no script or “right” way to feel, because each abortion is unique. 

Some people feel completely at peace with their decision, while others might need time to process the experience, especially if they felt pressure, lacked support, or had to navigate difficult circumstances to access care.

Common emotional experiences include:

• Relief that the process is over

• Sadness, even when confident in the decision

• Feeling isolated or misunderstood

• Gratitude for having had the choice

• Confusion or guilt, often influenced by stigma

Whatever you’re feeling, you’re not alone. Talking to someone you trust—like a friend, Doula counselor, or support line—can help you work through your emotions.

Warning Signs: When to Seek Medical Care

Bleeding is an expected and desired secondary effect—but there are limits.

Watch out for:

• Very heavy bleeding: Soaking through 2 pads per hour for 2 hours in a row (4 pads total) is considered too much.

• Fever lasting more than 24 hours

• Foul-smelling discharge

• Severe abdominal pain that doesn’t improve

• Fainting or feeling extreme fatigue

• Vomiting for more than 48 hours 

These symptoms could mean there’s an infection or another complication. If anything doesn’t feel right, don’t wait—reach out to a trusted health provider or to a Rouge Doula.

Do I Need an Ultrasound or Pregnancy Test After Using Abortion Pills?

You usually don’t need an ultrasound unless there are signs of an incomplete abortion or complications. In fact, some providers might recommend unnecessary procedures if an ultrasound shows normal tissue or blood as a result of still going through abortion termination process.

Instead, a home pregnancy test taken 3–4 weeks after the abortion is often the easiest way to confirm it worked. If the result is still positive or you’re not sure, follow up with a provider.

Can I Try the Abortion Again if It Doesn't Work?

Yes. If you’re still pregnant after taking abortion pills, you have options:

• Repeat the pills: depending on the method used, you may be able to try again:

  • If you used Mifepristone + Misoprostol, wait 72 hours before repeating.

  • If you used Misoprostol only and didn’t bleed, you can repeat right away.

• Surgical abortion: This may be available in some contexts, according to local laws for incomplete abortion treatment as a next step.

Abortion pills are safe to use again because they leave the body quickly and don’t cause long-term effects. If you’re unsure what to do next, get in touch with a Doula or provider who can guide you.

When Can I Have Sex Again?

You can have sex whenever you feel ready—physically, emotionally, and mentally. There’s no medical rule about waiting. It’s about what feels comfortable for you, and especially about your own desires. Just remember: You can get pregnant as early as 8 days after using abortion pills, even if you’re still bleeding. So if you don’t want to get pregnant right away, it’s important to use contraception.

What About Contraception?

Many people choose to start a birth control method right after an abortion. This is a personal decision—and your right.

Contraceptive Methods:

• Condoms are the only method that also protects against sexually transmitted infections (STIs).

• Other methods (pills, implants, IUDs, etc.) can be started soon after an abortion, as long as there are no complications.

• Fertility Awareness Method and Abstinence are alternative forms of contraception.

If you’re unsure which method suits you best, speak with a provider or counselor. If applicable, it can also be helpful to talk with your partner and make a plan together. Here is an excellent chart of birth control methods available fo

r your reference.

Final Thoughts on Sexual and Reproductive Health After an Abortion:

Having an abortion can be a meaningful, transformative experience. Your feelings matter, and your well-being deserves care and attention—just as much as your physical recovery. Taking care of your sexual and reproductive health after an abortion is about more than just physical recovery—it’s also about feeling empowered, informed, and supported. Give yourself time - emotions can shift and you don’t have to have all the answers right away.

• Avoid judgmental voices: Seek out people or spaces where you feel safe and respected.

• Reach out for support: If you feel overwhelmed, it can make a big difference to talk to a Doula or trusted friend.

• Practice self-care by: Staying informed, resting and eating healthy if possible,

• Healthcare: Seek medical care if anything feels off.

• Listen to your body and desires: Your intuition is the best indicator to address your needs.

Your choices and your well-being matter. If you have questions or need guidance, you’re not alone—support is available at  Rouge Pills here: Connect me to a Doula 

References:

1. World Health Organization (2022). Abortion care guideline. Retrieved from: WHO Abortion Guidelines

2. Ipas (2020). Clinical updates in reproductive health. Retrieved from: ipas.org

3. National Abortion Federation. (2024). 2024 Clinical policy guidelines for abortion care. Retrieved from: https://prochoice.org/providers/quality-standards/