Four Reasons You Could Still be Pregnant after Using Abortion Pills

Abortion pills are very effective at ending early pregnancies, and because they can be taken at home, or in place one deems safe, they can be a great alternative to surgical abortion care in a clinic, especially if you can't access one. And abortion pills aren't always used as a "less-good" substitute; some actually prefer the pills to a surgical abortion and opt for them as a first choice.

Abortion pills are medicines, and any medicine has a chance of not being effective. Let's take a look at why some people may not have an abortion after using misoprostol, either on its own or with mifepristone.

The pills you took were not abortion pills.

Unfortunately, there are fake abortion pills for sale online. Even if the website claims to be a partner of a reputable organization, there's no guarantee that the pills are real. If the misoprostol did not cause chills, nausea, diarrhea, or cramps, they were not the genuine article.

You have an ectopic pregnancy.

An ectopic pregnancy is one in which the fertilized egg implants outside the uterus, usually in the fallopian tubes. Abortion pills cannot terminate this kind of pregnancy.

Ectopic pregnancies are super dangerous and should be treated as a medical emergency- they can result in internal bleeding, and in a loss of fertility if the fallopian tube needs to be removed. Ectopic pregnancy cannot progress into a normal pregnancy, and the fetal tissue cannot be reimplanted.

Since ectopic pregnancies can only be diagnosed with an ultrasound,  you should seek medical attention if you have any of the following symptoms:

• Pelvic pain or discomfort, which increases
• Abnormal vaginal bleeding
• Shoulder pain
• Extreme lightheadedness or fainting

The pills were taken incorrectly/not enough were taken.

It's beyond normal to be anxious about medical situations, especially when you're pregnant and don't want to be. At the same time, abortion pills must be taken correctly in order to work, and that means taking enough of them.

If you're using the mifepristone + misoprostol method of medical abortion, you need one tablet of mifepristone and 4 tablets of misoprostol. Swallow that one tablet of mifepristone with a glass of water, and then, 24 hours after, put 2 misoprostol pills on the inside of each of your cheeks, using all 4 at the same time. Wait a 30 minutes for the pills to dissolve, and at that point, you can swallow what's left in your mouth. This method is 95-98% effective when used during the  \first 12 weeks of pregnancy.

If you're using misoprostol on its own, you need 12 pills of 200 mcgs each of misoprostol. Put 4 pills of misoprostol under your tongue, and don't swallow them for 30 minutes, until they're dissolved. After 30 minutes, you can swallow what's in your mouth. 3 hours later, you're going to repeat this with 4 more misoprostol, and 3 hours after that, you'll do it again with the remaining pills. You can eat and drink normally in between doses. Misoprostol alone is 80-85% effective up to 12 weeks.

Sometimes, it just doesn't work.

Unfortunately, even when abortion pills are taken correctly, it's just not happening. Misoprostol only works 80-85% of the time, and Mifepristone/Misoprostol works 95-98% of the time. The good news is that you can take the pills again after 3 days once you confirm that they didn't work. Before you do, though, make sure that none of the reasons we mentioned above are the case for you.

Women Help Women is here to answer your questions about self-managed abortion. WHW can help you access the pills, as well as give you scientific, stigma-free information about how they work, and what to expect. Go to abortionpillinfo.org for a secure link to our counselors!