How to Take Abortion Pills at Home in the UK (2025 Guide)

Quick Answer

A medical abortion (the abortion pills) in the UK involves two medications: mifepristone and misoprostol. First, you take one mifepristone tablet (200mg) by swallowing it with water. This blocks the hormone needed to maintain pregnancy. Then, after 24 to 48 hours, you take four misoprostol tablets - either by placing two on each side of your mouth (buccally) and letting them dissolve for 30 minutes, or by inserting all four high into the vagina and lying down for at least 30 minutes. Cramping and bleeding typically start within 1 to 4 hours after misoprostol. Most people pass the pregnancy within 6 to 12 hours. Pain relief such as ibuprofen is recommended, and a low-sensitivity pregnancy test should be taken after 3–4 weeks to confirm that the abortion was successful

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Introduction

If you are interested in our "at home abortion" service (abortion pills), you may want a step-by-step guide on how to take the abortion pill at home in the UK. This medically reviewed post walks you through:

• The correct way to take mifepristone and misoprostol (abortion pills).
• What to expect (pain, bleeding, symptoms).
• How to confirm the abortion was successful.
• When to seek medical help – plus access to 24/7 support.

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What Is a Medical Abortion or "Abortion Pills"?

A medical abortion uses two abortion pills - mifepristone and misoprostol - to safely end an early pregnancy at home. It’s approved in the UK for pregnancies up to 10 weeks and accounts for over 86% of abortions.

👉 Want to learn more about how the pills work? Read: What is the Abortion Pill?

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Why Is It Important?

Taking abortion pills the right way is critical to avoid pain, complications, or an incomplete abortion. Even though medical abortion is safe and 98% effective, misuse can lead to unnecessary stress or emergency care. This guide provides step-by-step instructions - so you feel informed, supported, and safe at home.

What’s Changed About Taking Abortion Pills at Home in the UK?

Taking abortion pills at home has become the most common and preferred method in the UK - but many women still don’t receive clear instructions on how to take them properly. Here’s what’s changed:

✓ Medical Abortion Is Now the Default

Over 86% of abortions in England and Wales are now done using pills - not surgery - and most are completed at home. This shift means more people are responsible for taking the pills themselves, often without face-to-face support.

✓ Pills by Post Has Changed How Care Works

Since COVID, the NHS and private providers like Top at Home have made it possible to get abortion pills through a virtual consultation and home delivery, but the instructions you receive vary widely.

❌ Lack of Step-by-Step Clarity Is a Common Problem

Many patients say they were unsure:

• When exactly to take the second pill (misoprostol)
  
• What symptoms are normal vs. concerning
  
• What to do if bleeding doesn’t start

This guide was created to fix that - offering trusted, medically reviewed instructions written specifically for home use.

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Who Is Most Likely to Take Abortion Pills At-Home?

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How to Take Abortion Pills at Home (Step-by-Step Guide)

Whether you choose NHS-funded care or a private CQC-registered provider like Top at Home, you’ll receive a medication abortion pack by post. It includes everything you need to complete a medical abortion safely at home - including mifepristone, misoprostol, pain relief, and a low-sensitivity pregnancy test.

📘 Want a printable version? [Download our Medical Abortion Treatment & Aftercare Guide]‍

Here’s what to expect:

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Step 1: Take Mifepristone (First Pill)

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🥣 Eat a light meal beforehand

We recommend eating something easily digestible (toast, crackers, or a small bowl of soup) 1–2 hours before taking mifepristone. This can reduce the risk of nausea or vomiting, especially if you’re prone to an upset stomach.

Dr. Aka explains: “Mifepristone blocks the hormone progesterone, which is needed to sustain a pregnancy. It’s the first step in preparing your body for the second pill, misoprostol."

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Step 2: Wait 24 - 48 Hours

After taking mifepristone, you’ll wait between 24 to 48 hours before taking the second pill (misoprostol).

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💡Tip: Use this time to emotionally prepare too - it can help to have someone you trust with you when you take the second set of pills.

Dr. Aka adds: “Just because you don’t feel anything doesn’t mean it isn’t working. This wait time is medically necessary - it gives your body time to respond to the first medication.”

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3. Take Misoprostol (Second Pill)

Misoprostol causes the uterus to contract and expel the pregnancy. You'll take it 24–48 hours after mifepristone - either in your mouth (buccal) or vaginally. Both methods are safe and equally effective, although at Top at Home, we recommend the Buccal method.

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Dr. Aka recommends: “Most people find the buccal method easier to do at home, especially if privacy or mobility is limited. Let all four tablets dissolve fully for 30 minutes before swallowing what’s left.”

💡Note: You may start feeling symptoms (cramps, bleeding, nausea) within 1–4 hours after taking misoprostol. That’s normal and means the medication is working.

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What Symptoms Will You Experience After Taking the Second Abortion pill?

Most people start feeling effects within a few hours of taking misoprostol. You might experience:

• Cramping (stronger than a period)
• Heavy bleeding with clots (up to lemon-size - normal)
• Nausea, diarrhoea, chills, or a mild fever

For most, symptoms are short-lived and manageable. 

But if you're further along (closer to 10 weeks) or have had previous pregnancies, pain may be more intense, sometimes described as labour-like contractions. 

Serious side effects (such as heavy bleeding requiring medical attention) occur in fewer than 0.4% of cases.

Dr. Aka notes: “Everyone’s experience with pain after taking the abortion pills is different - some people have only mild discomfort, while others need stronger relief. That’s why we include both ibuprofen and cocodamol in every Top at Home pack, and our team is here 24/7 to support you if you have any questions or concerns.”

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Step 4: How Do You Know If the Abortion Pill Worked?

To confirm that your abortion was successful, there are three signs to look for:

1. A negative pregnancy test after 3–4 weeks
   
2. Your period returns within 4–6 weeks
   
3. Pregnancy symptoms (like nausea or fatigue) go away
   
   

Why You Need a Special Pregnancy Test

Your abortion care kit includes a low-sensitivity pregnancy test, which is different from the ones sold in pharmacies or at Boots.

• Standard shop-bought tests may stay positive for up to 2 months - even if you're no longer pregnant.
  
• We use a HCG pregnancy test that is specially calibrated to detect the lower hormone levels expected after a successful abortion.
  
• This ensures a more accurate result around the 3-4 week mark

Still testing positive after 4 weeks? That may mean the abortion wasn’t fully complete. Call our 24/7 Gynaecologist line at: 0333 305 9004

Our team can help you book a follow-up assessment, scan, or additional care if needed.

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How long do you bleed after a medical abortion (abortion pills)?

Bleeding varies from person to person, and depends on how far along the pregnancy is.

• If you’re around 5–6 weeks pregnant (about 1–2 weeks after your missed period), bleeding may be lighter and pass more quickly.
  
• If you’re closer to 9–10 weeks (about 3–4+ weeks after your missed period), expect heavier bleeding, larger clots, and stronger cramping, especially in the first 4–6 hours after taking misoprostol.

Here’s what to expect:

• Heavier bleeding (with clots) for the first 1–2 days.
  
• Then lighter bleeding or spotting for up to 2–3 weeks.
  
• Use sanitary pads only until the bleeding stops - this helps you monitor clots and blood loss.
  
• Avoid tampons or menstrual cups during this time, as they can increase the risk of infection.

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How Long Does A Medical Abortion Take?

A medical abortion usually takes between 2 to 6 hours after taking the second pill (misoprostol), though it can take longer for some people.

Plan to rest during this time. It’s a good idea to have someone you trust nearby for comfort and support.

Top at Home abortion treatment pack includes:

• Ibuprofen and cocodamol for pain relief
• A heating pad recommendation
• 24/7 access to our medical team if your pain or symptoms feel unusual

Dr. Aka’s Advice: “Pain levels vary, but most people find ibuprofen (600–800mg every 6–8 hours) effective. Rest, a heating pad, and staying hydrated can also help.”

⏳ Timeline of Symptoms

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What if you’ve had no bleeding or only light spotting after 3 hours of taking misoprostol?

If you have not started bleeding or have only light spotting 3 hours after your first dose of misoprostol, take the 2 additional misoprostol tablets included in your pack using the buccal method (placing them between your cheek and gums to dissolve).

If you still have very little or no bleeding after taking the additional tablets, contact our 24-hour Gynaecologist line for advice, as the abortion may not have worked and further assessment may be needed

Why this happens:

In some cases, your uterus may not respond to the first dose right away. The second dose helps trigger the contractions needed to pass the pregnancy.

If you still don’t experience bleeding after the second dose, it may mean the medical abortion has not worked.

If you’re a Top at Home patient, you can call our 24-hour Gynaecologist line immediately: 0333 305 9004.

Our doctors will guide you through the next steps, which may include an assessment, follow-up scan, or referral for additional care.

Always reach out if you’re unsure - we’re here to support you.

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FAQs

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How long does it take to recover from a medical abortion?

Most people feel physically recovered within a few days after a medical abortion, though bleeding or spotting may continue for 1–3 weeks (and sometimes longer). Emotional recovery is different for everyone - it’s normal to feel relief, sadness, or a mix of emotions. You can return to normal activities as soon as your symptoms ease and you feel ready

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When can you get pregnant again after a medical abortion?

Fertility returns quickly after a medical abortion - you can ovulate as soon as 8–14 days after taking the abortion pills, and most people will ovulate within 2–3 weeks. If you want to avoid pregnancy, it’s important to start contraception immediately. Top at Home can offer guidance on contraceptive options as part of your aftercare

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Do I have to take time off work, school, or caregiving?

You will likely need to rest on the day you take misoprostol, especially during the first 6–12 hours when cramping and bleeding are strongest. Many people feel well enough to return to work, school, or caregiving within 1–2 days, depending on how they feel and the demands of their activities. It’s best to avoid strenuous exercise or heavy lifting until bleeding lessens.

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Can I take a bath or shower after taking the abortion pills?

You can shower any time, but it’s best to avoid baths or swimming for a few days, especially while bleeding heavily. This helps reduce the risk of infection while your cervix is open.

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Is it normal to pass large clots?

Yes, passing blood clots up to the size of a lemon is normal within the first 4–6 hours after taking misoprostol. If you pass clots larger than a lemon or soak through more than 2 pads per hour for over 2 hours, contact our 24/7 support line for advice

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A Note From Top at Home

At Top at Home, we believe abortion care should be clear, private, and without judgment. Whether you're choosing NHS-funded support or private pills by post, you deserve guidance that feels human - not clinical copy-paste.

If you’re ever unsure, our 24/7 doctor-led team is here to help. You don’t have to go through this alone.

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🔗 Related Guides

• What Is the Abortion Pill? (2025 Guide)
  
  
• Where to Get Abortion Pills by Post in the UK

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Sources & Expert Review

• NHS Abortion Guidelines
• Royal College of Obstetricians and Gynaecologists (RCOG)
• WHO Medical Abortion Standards
• Government Of UK

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Written by: Dr. Aka (GMC 4275695), Medical Director, Top at Home

‍Reviewed by: Dr. Ohizua (GMC 4446275), Consultant Gynaecologist, Top at Home

‍Last Updated: July 1, 2025