The abortion pill is FDA-approved for use through 10 weeks of pregnancy, counted as 70 days or fewer from the first day of your last menstrual period. That 10-week window is the key number: within it, medication abortion is highly effective and widely available from certified prescribers. Beyond it, options shift toward procedural abortion in most clinical settings.
How the 10-Week Limit Is Counted
Gestational age starts counting from the first day of your last period, not from the day you think you conceived. This means you’re already considered about four weeks pregnant by the time you miss a period. So if your last period started eight weeks ago, you’re at eight weeks gestation and still within the window for the abortion pill.
If you’re unsure when your last period was, or if your cycles are irregular, an ultrasound is the most accurate way to date a pregnancy. Ultrasound in the first trimester is more reliable than period-based dating, especially when cycles aren’t a consistent 28 days. If the ultrasound estimate differs from your period-based estimate by more than five days (before nine weeks) or more than seven days (between nine and fourteen weeks), the ultrasound date is typically used instead.
What the Process Looks Like
Medication abortion uses two drugs taken in sequence. On day one, you take the first pill by mouth. Then 24 to 48 hours later, you take four tablets of the second medication by placing them between your cheeks and gums and letting them dissolve. Taking the second medication too early (under 24 hours) or too late (over 48 hours) can reduce how well the regimen works.
The second medication triggers cramping and bleeding, which is the body expelling the pregnancy. The heaviest bleeding usually happens within 24 hours of taking those tablets, though some people experience heavy bleeding for up to 48 hours. Passing clots can continue for days or even weeks afterward, but bleeding that wraps up within two weeks is a good sign the process completed successfully.
Cramping ranges from moderate to intense during the heaviest bleeding. Many people describe it as significantly stronger than a normal period. The acute phase, where you’ll want to be home and resting, typically lasts several hours.
How Effectiveness Changes by Week
Within the approved 10-week window, the abortion pill works in the vast majority of cases. Success rates are highest earlier in pregnancy and gradually decline as gestational age increases. At nine weeks, research shows about 88 to 89% of people using both medications complete the abortion without needing any procedural follow-up. At 10 weeks, that number is around 87 to 88%.
Beyond 10 weeks, the regimen is used less commonly in clinical practice and isn’t part of the FDA-approved protocol, though some research has examined outcomes at later gestational ages. At 11 weeks, studies of self-managed medication abortion found complete abortion rates dropping to roughly 82%. The further along a pregnancy is, the more likely a follow-up procedure becomes necessary to complete the process. This is one reason the 10-week cutoff exists.
Confirming It Worked
After a medication abortion, you’ll need to confirm the pregnancy has ended. The standard approach is a follow-up about one to two weeks after taking the medications. This can involve a blood test measuring pregnancy hormone levels or, in some cases, an at-home urine pregnancy test. A negative home pregnancy test at around 14 days is a reliable indicator that the abortion is complete. A positive result at that point means further evaluation is needed, since it could indicate retained tissue or, rarely, an ongoing pregnancy.
Some providers use blood draws instead, checking whether hormone levels have dropped by at least 80% within about a week of taking the first medication. The method depends on your provider’s protocol and how far along you were.
Why Timing Matters
If you’re considering a medication abortion, earlier is generally better for two practical reasons. First, effectiveness is highest in the earliest weeks. Second, the experience tends to involve less bleeding and cramping at earlier gestational ages. The 10-week limit also means that delays, whether from scheduling, state-mandated waiting periods, or difficulty accessing a provider, can push you past the eligibility window entirely.
If you’re already past 10 weeks or close to it, a procedural abortion (also called aspiration or suction) is the standard alternative. It’s a brief outpatient procedure that remains an option well into the second trimester, depending on state law and clinic availability. Your provider can help you understand which option fits your timeline.