What is medication abortion?
Medication abortion is a two medication regimen that is used to induce an abortion. The first medication in the regimen, mifepristone, stops the pregnancy from growing. A second medication, misoprostol, induces cramping that causes the pregnancy to pass like a miscarriage. The World Health Organization guidelines outline that medication abortion can be safely used to end pregnancies up to 11 weeks gestation. You can watch the short video from International Planned Parenthood Federation for more information about what to expect.
When will I get the medication in the mail?
Once the medication has shipped, you will receive a tracking number to ensure timely arrival of your medication. Medication takes 2-4 business days to arrive. If you would like to receive your medication within 1-2 business days, express shipping is $25.
Where do the medications come from?
Medications are shipped by our partner pharmacy, Honeybee Health
I have a health condition. Is medication abortion still safe for me?
Medication abortion is a safe and effective option for most people in early pregnancy, even people with significant health conditions. Medication abortion is NOT recommended for people with any of the following:
- confirmed or suspected ectopic pregnancy (pregnancy outside the uterus)
- intrauterine device (IUD) in place (IUD can be removed before taking medication)
- current long-term systemic corticosteroid therapy
- chronic adrenal failure
- known bleeding disorder or anticoagulant therapy
- inherited porphyria
- intolerance or allergy to mifepristone or misoprostol
Telemedicine abortion (without blood testing or ultrasound imaging) is not recommended for people with a prior ectopic pregnancy, prior tubal sterilization, or other tubal surgery.
What can I expect when I take the medication?
Misoprostol causes cramping and bleeding, often with clots. The cramps and bleeding may be much more than you get with a period. The cramps usually start 2 to 4 hours after you use the pills and may last for 3 to 5 hours. The heavy bleeding means that the treatment is working. The bleeding often lasts 1 to 2 weeks but can last up to 4 weeks. It may stop and start a few times. You may see some pregnancy tissue (usually white or gray in color) with the bleeding.
What is an ectopic pregnancy and how do I know if I have one?
An ectopic pregnancy is a pregnancy that grows outside the uterus, usually in a fallopian tube. An ectopic pregnancy must always be treated with a surgery or medication. If not treated, an ectopic pregnancy can be life-threatening. A medical abortion is not effective treatment for an ectopic pregnancy!
If you use mifepristone and misoprostol to end a pregnancy without ultrasound imaging, there is always a small chance that you could have an undetected ectopic pregnancy (less than 2 in 100 pregnancies are ectopic). If you do not pass tissue and blood after taking the misoprostol, this might mean you have an ectopic pregnancy. Some signs that you may have an ectopic pregnancy which has burst are sudden or ongoing severe pain, feeling light-headed or faint, or pain in your shoulders. If you have these emergency symptoms, you should seek in-person medical help immediately. Ectopic pregnancies are treated even in places where abortion is severely restricted.
What is Rh factor and what does it have to do with pregnancy?
Rhesus (Rh) factor is a protein some people have in their blood. If your blood has this protein, you are Rh positive. If your blood does not have the protein, you are Rh negative. About 85% of people are Rh positive. For example, if your blood type is O+, you are Rh positive.
If you have vaginal bleeding during pregnancy (like with an abortion, miscarriage, or during labor), fetal blood cells can enter your blood stream. If you are Rh negative, this can cause your body to develop Rh antibodies. These antibodies can cause serious problems in future pregnancies. Evidence shows that this risk is extremely low in pregnancies that are less than 12 weeks, even if you are Rh negative.
Rhₒ(D) immune globulin (often referred to as RhoGAM) is a shot that can stop your body from producing Rh antibodies, so that you won’t have problems in future pregnancies. Current medical society guidelines DO NOT recommend RhoGAM for pregnancies less than 12 weeks. If you would like to know your blood type, you can do a blood typing test at home or at a lab near you.
How do I know if the medication worked?
There are a number of ways to confirm the success of medication abortion. We will check in with you after you take your pills to make sure you have had cramping and bleeding as expected and are no longer feeling pregnant. We include a medical grade home urine pregnancy test in your medication package and recommend using it 4 weeks after you have taken the pills to confirm that the abortion was successful and that you are no longer pregnant. If you continue to feel pregnancy symptoms (have breast tenderness, nausea, fatigue, etc.) for more than 2 weeks after taking the pills, get in touch with us. If you have any doubt that your pregnancy has ended, an ultrasound performed at a clinic can also confirm successful completion of an abortion.
What is the cost of medication abortion? Do you accept insurance?
We offer medication abortion and a complimentary prescription for birth control for $100. We are working on taking insurance however are unable to at this time. We will provide you with an invoice for your care, which you can send to your insurance for reimbursement if you choose. Please reach out to us if cost is a barrier for you and we’ll make sure you can get the care you need! We work in partnership with Abortion Freedom Partnership, New York Abortion Access Fund, and can offer sliding scale rates as appropriate to help all patients afford care they need.
What if I need in-person abortion care?
If you need in-person abortion care, we recommend finding a clinic near you through Abortion Finder, Abortion Care Network or National Abortion Federation. We can offer in-person care in the NYC area. Please get in touch for more details!
If you trying to reach us with questions after taking medication abortion pills and are unable to get in touch right away, please contact our partners at the Miscarriage & Abortion Hotline at 1.833.246.2632 for clinical questions.
If you are having an emergency, please go immediately to your nearest emergency department. It’s important to locate your nearest emergency department (within 1 hour) before taking medication abortion. If you need to seek care but are worried about your privacy, medication abortion has the same symptoms as a natural miscarriage. Therefore, you can say things like:
- I’m unsure what’s happening. I just started bleeding.
- I’m bleeding, but it doesn’t feel like my normal period.
- I just suddenly started bleeding and I’m afraid something is wrong.
Can you prescribe me birth control after my abortion?
We are happy to discuss birth control options with you and can provide you a prescription for any method you choose at no additional cost. If you have insurance, the cost of these medications is usually covered. Take a look at Bedsider for useful information about birth control methods.
Who can I talk to for support after an abortion?
If you need any additional support after an abortion, we are here for you. There are also a handful of wonderful organizations that provide free and anonymous support. You can check out our partner organization Reprocare’s healthline or try Exhale or Connect & Breathe.
Does having an abortion affect my chance of becoming pregnant again in the future?
No, medication abortion does not affect your fertility or increase your chance of miscarriage in the future
What if I’m unsure if I want to end my pregnancy?
Choosing abortion is not always straight forward. All Options and Safe2Choose provide great resources and have talk lines to help you find clarity.
Where are you located?
We currently offer telemedicine to patients located in New York, New Jersey, Connecticut, California, Colorado, and New Mexico State and are working on expanding to other states!
Is this service refundable? What if I change my mind?
Refund requests prior to shipment of medication: If you change your mind after making payment, but before medication has been shipped by Honeybee Health, you can request a partial refund. We will refund your payment minus a $25 consultation fee. Please allow 5-10 business days for funds to post to your account.
Refund requests after medications are shipped by Honeybee Health: We do not offer refunds once your medications have been shipped. The medication fees collected by Juniper Midwifery are collected on behalf of Honeybee and pharmacy refunds cannot be provided for medications even if the medications are returned to the pharmacy because returned medications must be disposed of.
Refund requests due to non-deliverable address on intake form or failure to pick up package from designated pick-up location: Because medications are non-refundable after being shipped, please ensure that delivery can be made to the shipping address you provide on your intake form.