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Pills by Post – Abortion Pill treatment at home

For women from England and Wales

(and NI in certain circumstances) 

If you are from Scotland and want to access Pills by Post please call us for more information.


Medical abortion: The abortion pill by post 

This service is a safe and legal way to end a pregnancy at an early gestation without needing to attend a clinic for treatment. You should contact BPAS on our bookings and information line 03457 30 40 30 (or if you are from Northern Ireland call 0300 500 8086) to book a telephone consultation and full medical assessment with a trained nurse or midwife who will assess your suitability for treatment. Most women are eligible for NHS funded treatment and we can discuss whether this applies to you when you call.  If treatment is suitable and safe, you will receive abortion pills by post a few days later, or we can book you for an alternative treatment in clinic.

Medical assessment

You will have your consultation and medical assessment over the telephone and have opted for remote abortion pill treatment (pills by post).  


We will explain the known risks and complications of your treatment during your telephone assessment. The risks and complications of this treatment are shown below.

Risks and complications of the abortion pill

Significant unavoidable or frequently occurring risks

These are usually easy to treat and rarely have any long-term health effects:

  • You may see a recognisable pregnancy
  • Unpredictable time to complete the procedure (variable)
  • Side effects of drugs such as nausea, vomiting, diarrhoea, headache, dizziness, fever/chills (common)
  • Retained products of conception - where the pregnancy is no longer growing but some of the pregnancy tissue is left behind in the womb (2 in 100)
  • Infection (2 in 1,000)
  • Unpredictable, irregular or prolonged bleeding after the abortion (variable)
  • Pain during the procedure (common)
  • Pregnancy being significantly later than realised (less than 1 in 1,000). Rarely if a much later pregnancy was not suspected, this may mean the abortion fails, there is more pain or bleeding, or in extreme circumstances a live birth

These may require transfer to hospital or surgical procedures, and may have serious long-term health effects:

  • Continuing pregnancy (less than 1 in 100)
  • Haemorrhage – very heavy bleeding (2 in 1,000)
  • Undiagnosed ectopic pregnancy (1 in 7,000)
  • Psychological problems (variable)

Extra procedures that may be necessary

  • Surgical abortion or uterine aspiration (3 in 100)
  • Blood transfusion
  • Laparoscopy or laparotomy – operation to look inside the abdomen
  • Hysterectomy – surgical removal of the womb (2 in 100,000)

Death is very rarely linked to abortion treatment (less than 1 in 100,000 for all abortions).


You will receive your treatment package direct from the pharmacy from 1 to 3 days from your telephone consultation (sometimes longer with Bank Holidays). If your package is delayed in the post for a few days you should still take the tablets as directed once they arrive. The package is plain with no indication of its contents, it will be tracked but not signed for.  Your pack will contain:

  • Medabon pack containing 1 tablet of mifepristone (step 1) and 4 tablets of misoprostol (step 2)
  • 2 plastic wrapped misoprostol tablets (step 3)
  • Pregnancy test (step 4)
  • Codeine (only provided if medically suitable)
  • Your chosen contraceptive pills, patches or rings (if requested and suitable) - you will need to supply your height, weight and blood pressure reading for patches, pills and combined hormonal pills.  Click for details where to get blood pressure readings

Click here to see what your package will look like (contents and medication brand names may vary)

About medical abortion: The abortion pill 

The abortion pill involves taking two medicines, mifepristone and misoprostol.

The first medicine, mifepristone, ends the pregnancy. It works by blocking the hormone progesterone. Without progesterone, the lining of the uterus breaks down and the pregnancy cannot continue.

The second medicine, misoprostol, makes the womb contract causing cramping, bleeding and loss of the pregnancy similar to a miscarriage.

How to take mifepristone and misoprostol

The timing when you administer your medication is important:

  • Step 1 - You will swallow the first medicine (mifepristone) with water
  • Step 2 - 1 to 2 days later you will take the second medicine (misoprostol)
  • Step 3 - 3 to 4 hours after the first dose of misoprostol, you will take another dose
  • You will then pass the pregnancy at home.

How to take mifepristone and misoprostol

Step 1 – Mifepristone

Swallow the mifepristone tablet with water.

You may have nausea or vomiting after swallowing the mifepristone. If you do vomit, you should still use the misoprostol as outlined below. Please telephone if you have any concerns or if you vomit within 30 minutes of swallowing the mifepristone.

Most women do not have bleeding or pain until they take the second medication (misoprostol). Bleeding can occur after taking mifepristone but it is usually light. If bleeding does happen, you should still use the misoprostol. Contact us if you have any concerns.

Click here for the video instructions

Step 2 and 3 – Misoprostol

Misoprostol tablets are placed in the vagina or between the cheek and gum. See below for more detail.

Misoprostol (the second medication) causes strong, painful cramps and heavy bleeding.

Bleeding and cramping usually start within 2 to 4 hours after using the tablets. Bleeding and pain are often greatest when the pregnancy is being expelled. Most women pass the pregnancy within 4 hours - timings vary, but it is OK if this happens sooner or later. Almost all women miscarry within a few days.

You may be given codeine to help you manage the pain and you can also use pain relief from supermarkets and pharmacies. Please refer to the ‘Pain Control’ section on this page, for information about managing your pain.

Instructions for using misoprostol (second medication)

You have been sent 6 tablets of misoprostol.

Click here for the video instructions

Step 2 – misoprostol

Use 4 tablets placed either in your vagina or between your cheek and gum.

Into the vagina

Insert 4 tablets as high as possible in the vagina; the exact location is not important only that they do not fall out. You can do this while lying down, squatting or standing with one leg up - whatever is most comfortable for you.

EMA misoprostol vaginal insertion


Into the mouth between cheek and gum

Place 4 misoprostol tablets into the mouth between the upper cheek and gum and allow the tablets to dissolve for 30 minutes. If the tablets have not completely dissolved within 30 minutes, you may swallow what is left with water.

EMA misoprostol in mouth

Some clients describe the taste of misoprostol as unpleasant and the texture as chalky. Placing the tablets between the cheek and gum is associated with higher rates of nausea, vomiting and diarrhoea.

Step 3 – repeat misoprostol

3 to 4 hours after the first misoprostol tablets, use the 2 remaining tablets by either placing them in your vagina or between your cheek and gum.

Passing the pregnancy (and bleeding)

Use sanitary towels to monitor your bleeding during abortion pill treatment. The amount and type of bleeding can vary for each person and each abortion. It is normal to experience light, moderate, or heavy bleeding during a medical abortion. Not everyone
will pass blood clots during a medical abortion, but for those who do, the clots should be no larger than a lemon. It is NOT normal to have no bleeding/scant bleeding or flooding (see the image below), therefore you should telephone BPAS on 0300 333 68 28
for advice if:

  • 24 hours after taking the misoprostol, you do not bleed at all, have spotting/only see blood on a tissue when wiping (see Scant image 1)
  • You experience heavy bleeding soaking 2 maxi size sanitary pads for 2 hours in a row (see Heavy image 4)

Call 999 if:

  • You experience extremely heavy bleeding (see Flooding image 5) and feel unwell

Bleeding and cramping usually start 2-4 hours after taking misoprostol but sometimes it can take up to a few days for this to happen. You may see other tissue when you pass the pregnancy. This is larger and more recognisable at higher gestations, but in most cases the fetus cannot be seen without magnification.

In rare circumstances, 0.1% of women pass pregnancy tissue which is further advanced in gestation than they thought it would be. If this happens to you please contact our Aftercare line for help and support.

Once the pregnancy passes, the amount of bleeding and cramping should noticeably reduce. It is likely you will feel cramping on and off for a week or so and this should be easily managed with ibuprofen or paracetamol. Most women have light bleeding for about 2 weeks, but you may have spotting up to your next period. Sometimes you may have a short episode of pain with a gush of blood or a clot several weeks after the abortion - contact us if this continues. 

Side effects

For most women, early medical abortion is like an early miscarriage. It is normal to have bleeding and cramping. You might also:

  • feel dizzy
  • feel nauseous, vomit and/or have diarrhoea (more likely when misoprostol is placed between the mouth and gum)
  • have a headache
  • have temporary hot flushes or sweats

If symptoms continue after 24 hours of taking the second medicine, please get in contact with us.

Pregnancy remains

You will pass the pregnancy at home or another place of your choosing. You can decide how you wish to dispose of the pregnancy remains. They can be flushed down the lavatory or wrapped in tissue, placed in a small plastic bag and put in the dustbin.

In rare circumstances, 0.1% of women pass pregnancy tissue which is further advanced in gestation than they thought it would be. If this happens to you please contact our Aftercare line for help, support and advice regarding disposal of pregnancy remains.  

If you have any other questions about the disposal of the pregnancy remains see pregnancy remains for more information.

Pain control

During an early medical abortion, most women will have a strong cramping, similar to period pains. There are many ways to lessen the pain:

  • wear comfortable clothes
  • stay in a familiar and relaxing place
  • apply a heating pad or hot water bottle to your lower stomach
  • use a pain medicine like ibuprofen and codeine

How to get pain medicine

You can buy ibuprofen tablets in 200mg or 400mg strengths and your pack may also contain codeine in 15mg or 30mg strengths. Codeine is not suitable for anyone under 12 years of age.

How to use these medicines

Ibuprofen is for mild to moderate pain. Codeine is for moderate to severe pain. Paracetamol can be used for mild to moderate pain by those who cannot take ibuprofen.

You can start with ibuprofen (or paracetamol) adding codeine when you need stronger pain relief. Or you can just start with codeine. Or alternate the medicines depending on how you feel.

What dose you should take and how often you can take it

Ibuprofen: Do not take more than 2.4g (2400mg) in 24 hours. Take 600mg to 800mg by mouth every 8 hours as needed.

Paracetamol 500mg: Do not take more than 8 tablets in 24 hours. You can take up to 2 tablets by mouth every 4 to 6 hours as needed.

Codeine 30mg: Do not take more than 8 tablets in 24 hours. Take 1 or 2 tablets by mouth every 4 hours as needed. If you are aged between 12 and 18 years, take 1 or 2 tablets by mouth every 6 hours as needed.

Codeine 15mg: Do not take more than 16 tablets in 24 hours. Take 2 or 4 tablets by mouth every 4 hours as needed. If you are aged between 12 and 18 years, take 2 or 4 tablets by mouth every 6 hours as needed.

Please note: Do not drive or operate machinery whilst taking codeine.

If you have tried these options, but still have pain, please call the Aftercare Line on 0300 333 68 28 (or +44 1789 508 210) for advice.

Click here for video instructions for pain management

After treatment

Follow-up instructions

The abortion pill is very effective and usually uncomplicated, but it is important to make sure it has worked. Having some cramping and bleeding does not guarantee that your treatment was successful. Misoprostol may cause serious birth defects if the pregnancy continues. If the abortion pill does not work for you, you should contact us to discuss your options.

  • You will NOT be contacted by BPAS to find out if your treatment has worked
  • You need to complete the ‘self-assessment checklist’ below to ensure your treatment has worked and that you are no longer pregnant
  • 3 weeks after starting your treatment, you should use the pregnancy test we sent you, with the first urine you passed when you woke up in the morning. (see below)

Click here for video instructions

Self-assessment checklist

I will contact BPAS if I experience any of the following signs that my treatment has not worked:

  • I did not bleed (or had only spotting, or only saw blood on a tissue when wiping) within 24 hours of taking misoprostol tablets
  • I had less than 4 days of bleeding
  • By the end of week 1, I still ‘feel’ pregnant or have symptoms of pregnancy such as sore breasts, sickness, tummy growing, etc.
  • 3 weeks after treatment, I performed the BPAS urine pregnancy test (using the first urine passed when I woke) and the test was positive, invalid, or I was not sure of the result
  • My next period has not come by 4 weeks after treatment (even if the pregnancy test was negative)

Telephone BPAS immediately on 0300 333 68 28 (or +44 1789 508 210) if you experience any signs listed above.

Pregnancy test instructions

The pregnancy test we sent with your medication should be used 3 weeks after you swallow the first medication (mifepristone). The pregnancy test should be performed using the first urine you pass after waking in the morning.

This is a diagram of your pregnancy test:

  • Remove all packaging
  • Remove the cap from the test
  • As you urinate, hold the absorbent tip of the test in the urine stream or collect some urine in a clean pot and dip the tip into the urine for 5 to 10 seconds

  • Wait 5 to 10 minutes
  • Read the pregnancy test


Our Aftercare Line is open 24 hours a day, 7 days a week. If you have any questions or are unsure about anything, please call 0300 333 68 28 (or +44 1789 508 210) for help.

What to expect after treatment 

Recovery after an uncomplicated abortion usually happens fairly quickly, but it is different for every woman. There are some things to expect, which are normal, and other signs and symptoms that are not. It’s important that you know about both.

Most women recover quickly after an abortion. How much pain and bleeding you experience afterwards can vary.


After an abortion, most women feel relieved, but some may also feel sad or guilty.

If you feel you need to talk to someone, you can call us on 03457 30 40 30 (or +44 1789 508 211) to make an appointment for post-abortion counselling. This is a free service for women who have had treatment at BPAS.

Physical symptoms as your body recovers

Symptoms of nausea, vomiting and tiredness usually stop within 3 days of an abortion. Sore breasts may last 7 to 10 days. Take ibuprofen or paracetamol if necessary for the pain.

Important/unexpected or unusual symptoms after treatment

Contact our Aftercare Line immediately on 0300 333 68 28 (or +44 1789 508 210) if:

  • you have heavy vaginal bleeding and have soaked through 2 or more large maxi pads an hour, for the last 2 hours
  • it is more than 24 hours since you took your misoprostol and you still feel sick, have abdominal discomfort, diarrhoea, nausea, vomiting or weakness
  • you have abdominal pain or discomfort that is not helped by medication, rest, a hot water bottle, or a heating pad
  • you have a fever of 38°C or higher
  • you have an unpleasant smelling discharge from your vagina
  • if treated without a scan (or your scan only showed a gestation sac and no yolk sac)
    • no or minimal bleeding 24 hours after using misoprostol
    • lower abdominal pain worse on one side
    • lightheadedness, dizziness or feeling faint
    • shoulder tip pain
  • if you were treated following a scan showing a pregnancy in your uterus and you have no or minimal bleeding 5 to 7 days after using misoprostol
  • if you have a positive pregnancy test or other sign listed on the self-assessment checklist

Telephone 999 for an ambulance if you experience any of the following:

  • loss of consciousness
  • severe allergic reaction
  • acute confused state
  • concern for a heart attack or stroke
  • chest pain
  • slurred speech
  • breathing difficulties
  • fits that aren’t stopping
  • you experience extremely heavy bleeding and feel unwell

More information

Other questions you may have

Does having an abortion increase my chance of getting breast cancer?

No, there is no proven association with breast cancer and abortion.

Can I continue breastfeeding during a medical abortion?

Both mifepristone and misoprostol pass into the breast milk but the amounts are small and should not cause any adverse effects in breastfed infants. Breastfeeding may continue uninterrupted following mifepristone and misoprostol. If breastfeeding an
infant under 6 months’ of age, express and discard milk whilst taking codeine and for the first feed after the last dose of codeine.

Will having an abortion cause problems with future pregnancies?

If your abortion is uncomplicated there should be no issues with future pregnancies as a result of the abortion.

There are no proven associations between abortion and future infertility, ectopic pregnancy or placenta praevia.

Having an abortion may be associated with future pregnancies ending before the due date. This risk appears to increase when someone has had more than one abortion.

How will I feel afterwards?

Every woman is different so they feel, experience and cope in a way individual to them. There is no evidence to suggest that you will experience any mental health issues as a result of an abortion. However, if you have a history of mental health problems you may still have those problems whether you choose to have the abortion or not.

What about travel after treatment?

Travel is not ideal in the first 24 hours after using misoprostol. You may experience symptoms whilst in transit. You will need to know how to access emergency services in case of a complication.

What about contraception and STI Screening?

Routine STI screening is recommended for all women having an abortion. Almost all methods of contraception can be started on the same day as medical abortion or the day after. If you choose intrauterine contraception (IUD or coil) this can be inserted as soon as the abortion is complete. If you live in England, Scotland or Wales, you can see your GP or local contraception and sexual health service to obtain contraception after treatment.

To locate your nearest NHS contraception or service or STI clinic visit the following websites:

England www.nhs.uk/service-search

Northern Ireland www.informingchoicesni.org 

Scotland www.sexualhealthscotland.co.uk/get-help/sexual-health-service-finder

Wales www.nhsdirect.wales.nhs.uk/LocalServices

Feedback and complaints

If you want to provide any feedback about the service you have received, please email clientservices@bpas.org

After treatment we will email you with a link to complete our satisfaction survey, if you agreed that we may do so.

There may be times you want to feedback formally or raise a complaint with us. Find out more about BPAS complaints and feedback here.

To raise a complaint you can:

  • speak to a member of staff
  • call 0345 365 50 50 (or +44 1789 508 211) and ask to speak to the Client Engagement Manager. If you are deaf or hard of hearing and use a textphone you can call 0345 365 1450 (or +44 1789 416 584)
  • write to the Client Engagement Manager, British Pregnancy Advisory Service, 20 Timothys Bridge Rd, Stratford Enterprise Park, Stratford-upon-Avon, CV37 9BF, or email clientservices@bpas.org