In the United States, you can get abortion pills through an in-person clinic visit or through a telehealth appointment that ships the medication to your home by mail. The two-pill regimen is FDA-approved for use up to 10 weeks of pregnancy (70 days from the first day of your last period). Where you live, how far along you are, and your state’s laws will determine which route is available to you.
The Two Medications and How They Work
A medication abortion uses two drugs taken in sequence. The first, mifepristone, is a single pill taken by mouth. It blocks the hormone that sustains a pregnancy. The second, misoprostol, is four smaller tablets placed between your cheeks and gums (called buccal administration) 24 to 48 hours later. Misoprostol causes the uterus to contract and empty. Taking misoprostol too early or too late outside that 24-to-48-hour window can reduce how well the regimen works.
Finding a Provider
Your two main options are visiting a clinic in person or using a telehealth service. Both end with you taking the same medications at home.
For in-person care, Planned Parenthood locations across the country provide medication abortion, and the National Abortion Federation runs a hotline (800-772-9100) that can connect you with verified providers. AbortionFinder.org maintains the largest directory of trusted abortion providers in the U.S., with more than 750 verified health centers listed. These tools let you search by zip code and filter by the type of care you need.
For telehealth, several services allow you to have a video or phone consultation with a licensed provider, who then mails the pills to you. The process typically involves filling out a medical questionnaire, confirming how far along you are (often by your last menstrual period rather than an ultrasound), and having a brief consultation. In one study comparing the two pathways, only about 18% of telehealth patients had a dating ultrasound compared to 100% of in-clinic patients. If there’s any uncertainty about how far along you are, a provider may recommend an ultrasound before prescribing.
One thing to expect with telehealth: you may find yourself reaching out to the provider’s office more often with questions. Research found that nearly half of telehealth patients made unscheduled calls to staff, compared to about one in five in-clinic patients. This is normal and not a sign that anything is wrong. It simply reflects that you’re managing the process at home without a nurse nearby.
How State Laws Affect Access
Abortion laws vary dramatically by state. Some states ban medication abortion entirely, while others protect access and even allow providers to prescribe across state lines through what are known as shield laws. Currently, 22 states and Washington, D.C., have some form of shield law protecting reproductive health care. Eight of those states explicitly allow providers to prescribe via telehealth regardless of where the patient is located, which is how some mail-order services operate.
If you live in a state with restrictions, you may need to travel to a state where abortion is legal or use a telehealth service based in a shield-law state. AbortionFinder.org and the National Abortion Federation hotline can help you navigate this.
What It Costs
A medication abortion can cost up to around $800, though the average price at Planned Parenthood is about $580. Telehealth services often fall in a similar range, and some charge less.
Insurance coverage is complicated. The federal Hyde Amendment has banned Medicaid from covering abortion for decades, with exceptions only for rape, incest, or life endangerment. Twenty states use their own funds to cover abortion through Medicaid anyway. On the private insurance side, 12 states require plans to cover abortion (nine of those with no copay), while 25 states ban coverage in marketplace plans and 10 restrict coverage in private plans more broadly. If you’re unsure whether your plan covers it, call the number on the back of your insurance card and ask directly.
If cost is a barrier, abortion funds can help. The National Network of Abortion Funds connects people with local organizations that cover not just the procedure but sometimes transportation, lodging, and childcare. You’ll need to have an appointment scheduled before you can apply for funding, so book first, then search for financial help.
What to Expect Physically
The first pill (mifepristone) usually causes few noticeable symptoms. The real physical experience begins after you take the second set of pills (misoprostol). Within one to four hours, you’ll start bleeding and cramping. Over the next several hours, expect heavy cramping with blood clots. The sensation is most often described as strong period cramps. Some people also experience a low-grade fever, chills, nausea, dizziness, fatigue, or diarrhea, typically lasting about a day.
Plan to be at home with nothing scheduled for the rest of that day. Have heating pads, ibuprofen, water, and comfortable clothing ready. The heaviest bleeding lasts one to two days, then gradually tapers over two to three weeks. Light to moderate bleeding may continue for several weeks, which is normal.
Follow-Up After Taking the Pills
Most providers will ask you to confirm the abortion is complete, either through a follow-up appointment, a phone check-in, or a home pregnancy test taken a few weeks later (earlier tests can give misleading results due to lingering pregnancy hormones). In a small percentage of cases, the medication does not fully complete the process, and a brief in-clinic procedure may be needed. Signs to watch for include soaking through more than two thick pads per hour for two or more hours, a fever lasting more than 24 hours, or no bleeding at all after taking misoprostol.