How to Take the Medical Abortion Pills and Other Medications: A Step-by-Step Guide

Key Takeaways

✔️ Step 1 (Mifepristone): Take with water and plan Step 2 within 24–48 hours.

✔️ Ondansetron: Take 1 hour before misoprostol to prevent nausea.

✔️ Ibuprofen: Take 30 minutes before misoprostol to help with cramping.

✔️ Step 2 (Misoprostol): Place in cheeks for 30 minutes, then swallow any remaining fragments.

A medical abortion using (mifepristone + misoprostol) is a safe and effective process, but following the correct timing and medication protocol is essential for the best outcome. This guide outlines how to take MS-2 Step, along with supportive medications, using Jane’s experience as an example.

Jane Case Study:

Step 1: Taking Mifepristone

📅 1st March

• Jane receives her medication and Thrive Package from Aunty Jane. She and her partner review the Support & Information Guide to ensure they understand the process.
• Later that evening, at 18:00, Jane takes Step 1 (Mifepristone) by swallowing the single tablet with a full glass of water.
• Mifepristone works by blocking progesterone, a hormone necessary for pregnancy to continue.
• Jane plans to take Step 2 (Misoprostol) at 08:00 on the 3rd of March, which falls within the recommended 24–48 hour window after Step 1.

Step 2: Preparing for Misoprostol

📅 3rd March – The Morning of Step 2

🕖 07:00 – Taking Ondansetron for Nausea

• Jane takes 8 mg of ondansetron (2 tablets) to prevent nausea and vomiting.
• She places the tablets on her tongue, allowing them to dissolve before swallowing the remaining fragments with a sip of water.
• Taking ondansetron 30–60 minutes before misoprostol helps reduce the chance of vomiting, ensuring the medication is fully absorbed.

🕠 07:30 – Taking Ibuprofen for Pain Management

• Jane takes 1600 mg of ibuprofen (4 tablets) by swallowing them with a sip of water.
• Ibuprofen helps reduce cramping pain, which is expected once misoprostol begins working.
• Preloading with ibuprofen before misoprostol is recommended to help manage discomfort early.

Step 3: Taking Misoprostol

🕗 08:00 – Taking Step 2 (Misoprostol)

• Jane takes Step 2 (Misoprostol) by placing four tablets (two on each side) inside her cheeks (buccal administration).
• She sets a timer for 30 minutes to allow the tablets to dissolve.
• Why wait 30 minutes? Misoprostol is absorbed through the mucous membranes in the mouth. Allowing it to dissolve maximizes absorption and effectiveness.
• After 30 minutes, Jane swallows any remaining fragments with a small sip of water.

What Happens Next?

After taking misoprostol, Jane can expect:

✅ Cramping and bleeding within 1–4 hours, which confirms the medication is working.

✅ Bleeding should be heavier than a normal first-day period within 24 hours.

✅ Symptoms like nausea, chills, or diarrhea are common and usually temporary.

At Aunty Jane, we prioritise safety, comfort, and informed choice. If you have any concerns during your medication abortion, reach out for support—we’re here to guide you every step of the way. 💜

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. 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
2. Better Health Channel. (n.d.). Abortion procedures – Medication. Retrieved February 5, 2025, from https://www.betterhealth.vic.gov.au/health/healthyliving/abortion-procedures-medication
3. Primary Care Connect. (n.d.). MS-2 Step patient information booklet. Retrieved February 5, 2025, from https://primarycareconnect.com.au/files/MS-2-Step-Patient-information-booklet.pdf