Vomiting After Taking Abortion Pills: What You Need to Know

When taking the medical abortion pills (mifepristone + misoprostol), it’s important to understand how vomiting may impact the effectiveness of the medication. While nausea and vomiting are common during pregnancy, knowing when vomiting may require reassessment can help ensure the treatment works as expected.

Step 1 (Mifepristone) – What to Do If You Vomit

• If you vomit within 30 minutes of swallowing mifepristone, the medication may not have been fully absorbed. You will need an assessment to determine if a second dose is required.
• If you vomit after 30 minutes, the medication has been fully absorbed, and no further action is needed.

Step 2 (Misoprostol) – What to Do If You Vomit

• Misoprostol is taken buccally (dissolved in the mouth for 30 minutes before swallowing the remainder).
• If you vomit while the tablets are still dissolving, you may need an assessment and possibly a second dose to ensure full effectiveness.
• If you vomit after swallowing the dissolved tablets, the medication has already been absorbed, and no further action is needed.

Case Study 1: Vomiting After Step 1

Jane is taking her MS-2 Step medication at home. At 10:00 AM, she swallows Step 2 (misoprostol) as directed. 35 minutes after swallowing Step 1 (mifepristone), she experiences a moderate episode of vomiting, triggered by pregnancy-related nausea. Concerned about whether the medication has been absorbed, she contacts Aunty Jane for guidance.

Nurse Jane assesses the situation and reassures her that because she held down Step 1 for more than 30 minutes, the medication has already taken full effect, and no additional dose is required. Jane is advised to continue with Step 2 as planned and monitor for expected symptoms, such as cramping and bleeding.

Case Study 2: Vomiting After Step 2

Jane follows the MS-2 Step protocol, taking Step 2 (misoprostol) 36 hours after Step 1 (mifepristone). To help manage nausea and discomfort, she takes ondansetron and ibuprofen as prescribed before proceeding.

She places the Step 2 misoprostol tablets in her mouth, allowing them to dissolve for 30 minutes, before swallowing the remainder with a small sip of water. 15 minutes later, Jane vomits and becomes concerned about whether the medication has been fully absorbed. She calls Aunty Jane for an assessment.

Nurse Jane reassures her that because she held the misoprostol in her cheeks for the full 30 minutes, the medication has already been absorbed, and no additional dose is required.

Jane is advised that within 24 hours, she should expect to bleed more than her normal first-day period, which confirms that the abortion process is progressing as expected. If she experiences less bleeding than this, she should call back for a further assessment.

Key Takeaways

✔️ If vomiting occurs within 30 minutes of Step 1 (mifepristone), reassessment is needed.

✔️ If vomiting occurs after 30 minutes of Step 1, no further action is required.

✔️ If vomiting occurs while Step 2 (misoprostol) is dissolving in your mouth (within 30 minutes), a second dose may be needed.

✔️ If vomiting occurs after swallowing the remainder of Step 2 (after 30 minutes), no further action is required.

✔️ Bleeding should be heavier than a normal first-day period within 24 hours of Step 2—if not, reassessment is required.

At Aunty Jane, we are here to ensure that every person has the information, support, and care they need for a safe and empowering abortion experience. 💜

The information provided on this website by Aunty Jane in any format or medium, are for general information purposes only and are not intended as medical advice or as a substitute for consultation with a qualified healthcare professional. The information made available by Aunty Jane do not provide personalised medical advice, diagnosis, or treatment. To the extent permitted by law, Aunty Jane disclaims all liability for any outcomes resulting from reliance on the information provided. For specific medical concerns, please consult a qualified healthcare professional.

1. Healthdirect Australia. (n.d.). MS-2 Step: Medical abortion medicine. Retrieved February 5, 2025, from https://www.healthdirect.gov.au/ms-2-step-medical-abortion-medicine
2. NPS MedicineWise. (n.d.). Mifepristone and misoprostol (MS-2 Step) composite pack: Use extended to 63 days gestation. Retrieved February 5, 2025, from https://www.nps.org.au/radar/articles/mifepristone-and-misoprostol-ms-2-step-composite-pack-use-extended-to-63-days-gestation
3. Family Planning NSW. (n.d.). Medical abortion fact sheet. Retrieved February 5, 2025, from https://www.fpnsw.org.au/sites/default/files/assets/Factsheet_Medical-Abortion.pdf
4. Better Health Channel. (n.d.). Abortion procedures – Medication. Retrieved February 5, 2025, from https://www.betterhealth.vic.gov.au/health/healthyliving/abortion-procedures-medication