How Far Into a Pregnancy Can You Use the Abortion Pill?

Although the Food and Drug Administration (FDA) currently recommends medication abortion for up to 10 weeks into a pregnancy, the abortion pill could be safe and effective beyond that timeframe.

The World Health Organization recommends the abortion pill for up to 12 weeks into a pregnancy, but affirms that the regimen is safe and effective for up to 14. Some studies suggest that medication abortions as late as 13 to 15 weeks gestation appear safe and effective.

Doctors and researchers said there is no sharp cutoff for when the abortion pill will stop being effective at terminating a pregnancy, but people at later stages of pregnancy usually require higher doses of the treatment.

The 10-week FDA recommendation is not a requirement, so healthcare providers are free to prescribe the pill later into a pregnancy, as long as the law does not prohibit them from doing so. In the United States, many providers prescribe abortion pills up to 10 and 12 weeks of pregnancy.

Administering the Pills Vaginally or Orally

The abortion pill can be administered vaginally, buccally (held in between the cheek and gums for 30 minutes before swallowing) or sublingually (held under the tongue for 30 minutes before swallowing).

Melissa Grant, chief operations officer of carafem Health Center, said each method is safe and effective and allows the the pill to be absorbed into the bloodstream.

“It’s up to preference. Some people feel very uncomfortable inserting their fingers into their vagina and that’s OK. We have other routes that can work,” Grant told Verywell. If people are prone to nausea, they may not want to take the pills orally, she added.

Daniel Grossman, MD, director of the research group Advancing New Standards in Reproductive Health at the University of California San Francisco, told Verywell that people who are at later stages of pregnancy may want to consider the oral route for legal reasons.

“There’s really no test that can be done to determine if someone has [swallowed] medications to end a pregnancy on their own,” Grossman said. “But if tablets are identified in the vagina, that could be a way that potentially people could be identified. So that is just something to be aware of and think about.”

When an Extra Dose of the Abortion Pill Is Needed

People who are performing a medication abortion at nine or more weeks into a pregnancy may require a higher dose of the second pill, misoprostol, in order to fully terminate the pregnancy, Grossman said.

The recommended protocol is to take another three or four pills of misoprostol about three hours after the initial dose, and repeat this consecutively every three hours until expulsion happens.

Patients may experience bleeding or see fleshy tissue or the embryo, depending on how far along into the pregnancy they are, Grossman said.

Later stages of pregnancy do not require higher doses of mifepristone, the first pill in the regimen. In fact, the recommended dose of mifepristone was dropped from three pills to one in 2016 when researchers determined that the extra pills were not inducing a different response in the body.