Abortion with Pills After 12 Weeks

People all across the world have abortions with pills at home after 12 weeks. Studies show taking abortion pills after 12 weeks can be medically safe and effective. After 12 weeks, an abortion with pills can take longer, requires multiple doses of misoprostol, and ends with pregnancy tissue that is more developed (usually a fetus + placenta). It’s important to have accurate information, be prepared for what to expect, and know who to contact for medical, emotional, and legal support.

Do abortion pills work after 12 weeks?

Yes, it’s medically effective to take the pills after 12 weeks. Studies show that when using mifepristone + misoprostol, the pregnancy ends 94-97% of the time. When people keep taking the misoprostol every 3 hours until the pregnancy passes, success rates are as high as 99%.

It’s also medically safe to take the pills after 12 weeks. The risk of life-threatening complications (like needing a blood transfusion) is less than 1%. It's safer than many commonly used medications, including penicillin and Tylenol.

Taking abortion pills after 12 weeks

The first step is taking 200mg of mifepristone. This is usually 1 pill and you can swallow it with or without food.

The second step is to wait between 24 and 48 hours. This ensures maximum effectiveness. Any time in the 24-48 hour window is fine - whatever is most convenient for you.

The third step is taking 2 misoprostol pills (400mcg) every 3 hours until the fetus and placenta are out. Do not swallow these pills. They should be held under the tongue or in the cheek pocket for 30 minutes or until they dissolve, or inserted into the vagina and allowed to absorb for 30 minutes. The dose needs to be repeated every 3 hours until the fetus and placenta are out. It's best to avoid pauses or interruptions.

On average, the fetus comes out 6-10 hours after the first misoprostol dose. This means most people only need 3-4 doses of misoprostol. However, there is a wide range of normal timing, and some people need 5 or more doses of misoprostol. It’s helpful to clear your schedule for 12-24 hours to complete the process. Most people will only need 6-10 misoprostol pills, but having 12-16 pills on hand is helpful.

What should I expect if I take the pills after 12 weeks? Will I see a fetus?

It can vary a lot, depending on how far along the pregnancy is. The further along the pregnancy is, the larger and more developed the fetus will be (with a head, arms, and legs). It can be surprising to see the fetus, so it’s good to be aware of this ahead of time.

To give you a sense of how large the fetus might be based on how long you’ve been pregnant, we’ve broken down size ranges with candy since candy is easily available and a consistent size.

12-13 weeks

At 12-13 weeks, the average fetus is around 2.5-3 inches long, or about the length of a TicTac box.

14 - 15 weeks

At 14-15 weeks, it is around 3-4 inches long, or about the length of a Dum Dum or KitKat bar.

16 - 17 weeks

At 16-17 weeks, the fetus is on average around 4.5-5 inches long, or about the length of 2 Reese's peanut butter cups.

after 18 weeks

At 18-19 weeks, it is around 5.5-6 inches long, or around the length a Hershey's bar.

Starting around 18 weeks, the fetus may have spontaneous gasping or movements. These are not necessarily signs of viability and typically stop on their own, but it can be stressful to watch.

Taking the pills after 22-24 weeks can potentially result in a premature delivery / live baby.

Things people consider

When having an abortion with pills at home, it’s good to think ahead of time about:

• WHEN / what time of day or night you’ll take the pills. It’s good to clear at least one day (the day you take the misoprostol) from work or school and arrange for child care if needed.
• WHERE you will be when you take the pills. Think of someplace private where you feel comfortable. It’s nice to have access to a toilet for that day.
• WHO you want with you – if anyone.
• WHAT are all the things you’ll need – think of things like preparing light meals or snacks ahead of time, having some comfort items, etc.
• HOW you will dispose of the pregnancy tissue
• HOW you will get to a hospital in the rare case of a complication

Can I get in trouble for taking the pills after 12 weeks? What are the legal risks?

The short answer is: it depends, and it’s complicated. Legal risk can depend on:

• What state you live in - Taking abortion pills is not a crime in most states. But some states have abortion bans or gestational age limits on when health care professionals can provide abortions, and these laws can lead people to be charged with crimes that don’t specifically have to do with abortion.
• How far along the pregnancy is - after 12 weeks, the fetus is larger and more developed, which makes it easier to recognize, impacts the way law enforcement responds to abortion, and increases risk of criminalization.
• Individual characteristics like race, socioeconomic status, gender identity, etc. Historically, Black and brown, low-income, and queer people have been disproportionately criminalized - including when pregnant.
• Who knows what - People have been reported to police by healthcare providers, friends, and /or family that they’ve told about the abortion. People experiencing intimate partner violence are also at greater risk of being reported to police by an abuser.

In the past, the likelihood of having a legal problem after taking abortion pills at home has been very low. According to If/When/How, from 2000 to 2020 there were at least 61 cases in the US of people being criminally investigated for self-managing their abortion. 87% of those cases were people in their second or third trimester. While most cases were resolved without consequences like incarceration, having any interaction with the legal system can be traumatic and cause lasting harm.

Since we lost the federal right to abortion (Roe v. Wade) in 2022, many states have passed different kinds of abortion laws. It is still unknown how these new abortion laws will affect future criminalization of people for self-managing an abortion.

For tips on how to keep your abortion private:

• Be mindful about who you talk to about your abortion
• Learn about digital security and privacy.

This content was developed in partnership with the team at Abuzz. If you have feedback on how to improve this informational article, please email ineedana@protonmail.com.