What to Expect Before, During, and After a Medication Abortion (Abortion Pill) in Virginia

The process typically takes place over 24 to 48 hours, and the process is completed at home. If you’re considering a medication abortion in Virginia, here’s what you need to know about how it works, what it feels like, what the risks are, and what comes next. There are options for you to reverse the abortion pill process if you regret taking the pill but its important that you reach out as soon as possible.

At The Keim Centers, we provide free pregnancy testing, free limited obstetric ultrasounds, and confidential pregnancy options counseling at five locations across southern Virginia. 

We don’t provide or refer for abortion services, but we offer medically accurate information about all your options so you can make a fully informed decision. 

Schedule a free, same-day appointment.

What is a medication abortion (what is the abortion pill)?

A medication abortion is a non-surgical way to end a pregnancy using two prescription drugs: mifepristone and misoprostol. It’s sometimes referred to as “the abortion pill,” though it actually involves two separate medications taken at different times.

Here’s how the two medications work together:

Mifepristone is the first drug in the regimen. It blocks the hormone progesterone, which is needed to sustain a pregnancy. Without progesterone, the lining of the uterus breaks down and the baby’s heart stops beating. 

Misoprostol is the second drug, taken 24 to 48 hours after mifepristone. It causes the uterus to contract and expel the baby. This part of the process involves cramping and bleeding that is similar to a heavy miscarriage (typically much heavier than a normal period).

According to the Guttmacher Institute, medication abortion accounted for approximately 63% of all clinician-provided abortions in the United States in 2023. It has been available in the U.S. since the FDA approved mifepristone in 2000.

How far along can you be to take the abortion pill?

The abortion pill regimen is FDA-approved for use up to 10 weeks (70 days) from the first day of your last menstrual period. Though abortion pills may be offered by some providers after ten weeks, they are only approved by the FDA up to 10 weeks. Additionally, abortion pills are less effective if taken after 10 weeks, which can result in an incomplete abortion requiring surgery to complete the abortion process.

This is one reason why confirming how far along you are matters before pursuing any type of abortion. A limited obstetric ultrasound can give you the most accurate estimate of your gestational age. 

At The Keim Centers, we offer abortion consultation at all five of our Virginia locations to help you understand where you are in your pregnancy before making any decisions and learning about all the options available to you.

What should I do before taking the abortion pill?

Before starting a medication abortion, it’s important to confirm your pregnancy, determine how far along you are, and rule out an ectopic pregnancy through an ultrasound.

Here’s why each of those steps matters:

Confirm your pregnancy. Home pregnancy tests are generally reliable, but a clinical-grade pregnancy test can confirm results. At The Keim Centers, we provide free pregnancy testing with same-day appointments. 

Determine how far along you are. Knowing exactly how far along you are helps determine whether medication abortion is an option for you. A limited obstetric ultrasound gives the most accurate reading.

Understand all your options. It’s important that you think through all your available options to decide if this is really what you want. You shouldn’t be pressured to abort your baby by anyone else, and you should understand that there are other options out there besides abortion. The Keim Centers is here to help you understand these options. 

Rule out ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most often in a fallopian tube. This condition can be life-threatening and cannot be treated with the abortion pill. According to the Mayo Clinic, ectopic pregnancy requires immediate medical attention. An ultrasound is the standard tool used to confirm whether a pregnancy is located inside the uterus.

Additionally, Virginia law requires that a physician or qualified nurse practitioner obtain informed written consent before performing an abortion. This means you have the right to be fully informed about the procedure, its risks, and any alternatives before making your decision.  You also have the right to withdraw your consent at any time as well.

What happens after I take the abortion pill?

The abortion pill, also known as medication abortion, is a two-step process that usually takes place over one to two days, with most of the physical experience happening at home.

Step 1: Mifepristone. This medication is taken first. It blocks progesterone and causes the uterine lining to break down. Most women don’t experience significant symptoms after taking this first pill, though some report mild nausea.

Step 2: Misoprostol. This is taken 24 to 48 hours later. It triggers uterine contractions and bleeding to expel the baby. This step is done at home.

After taking misoprostol, most women begin experiencing cramping and bleeding within one to four hours. The intensity can vary, but many women describe it as significantly heavier than a normal period. You may pass blood clots and tissue during this time.

In Virginia, medication abortion is also available via telehealth. A provider can prescribe the medications during a video consultation and have them mailed to a Virginia address. 

However, whether you receive pills in-person or via telehealth, having access to follow-up medical care is important. It is very dangerous to order pills online because you do not know what you are really ordering or if you are actually speaking to a licensed doctor. Also, the FDA does NOT recommend buying abortion pills online (https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/information-about-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation)  

What are the side effects of the abortion pill?

Common side effects include heavy bleeding, cramping, nausea, vomiting, diarrhea, fever, and chills. These are expected parts of the process, not complications.

Bleeding and cramping are the most prominent effects and can last for varying lengths of time. Many women experience bleeding for up to two weeks, with some spotting lasting up to four weeks. Cramping is typically most intense in the hours after taking misoprostol and then gradually decreases.

Other commonly reported side effects include headaches, dizziness, fatigue, and breast tenderness. These tend to be temporary.

What are the risks of the abortion pill?

Medication abortion, also known as the abortion pill, carries serious medical risks that are important to understand before making your decision. The Keim Centers is here to help you understand all of your options before you make a decision. 

Potential risks and complications include:

• Incomplete abortion, which occurs when the baby remains in the uterus. This may require a follow-up surgical procedure (aspiration) to complete the process.
• Heavy or prolonged bleeding that goes beyond what’s expected. If you’re soaking through two or more thick pads per hour for two or more consecutive hours, seek medical attention immediately.
• Infection, which can develop if the baby remains or bacteria enter the uterus during the process.
• Allergic reaction to the medications, though this is rare.

Symptoms that require emergency medical attention include: a fever of 100.4°F or higher lasting more than 24 hours, heavy bleeding that doesn’t slow down, severe abdominal pain that is not relieved by over-the-counter medication, and foul-smelling vaginal discharge.

The FDA reports that medication abortion using mifepristone and misoprostol is effective in approximately 95-98% of cases when used within the approved timeframe.  

Approximately 10% of women experience sepsis, infection, hemorrhaging, or another serious or life-threatening adverse event within 45 days following a medication abortion (Ethics and Public Policy Center, April 2025). 

How much does an abortion cost in Virginia?

The cost of an abortion in Virginia generally ranges from $300 to $800, depending on your provider, location, how far along you are, and insurance coverage. Some providers charge more for additional services like lab work or follow-up visits.

Virginia Medicaid restricts coverage of abortion to cases involving rape, incest, a threat to the life of the pregnant person, or a documented abnormality in the pregnancy. Some private insurance plans may cover the procedure partially or in full, depending on your policy.

At The Keim Centers, our pregnancy testing, ultrasound, and abortion counseling services are always 100% free. 

We can help you confirm your pregnancy and understand how far along you are before you make any decisions. 

Schedule a free appointment here.

What if I change my mind after taking the first pill?

Some women who have taken mifepristone (the first medication) decide they no longer want to proceed with the abortion. If progesterone is administered within 72 hours of taking mifepristone and before taking misoprostol, it may be possible to continue the pregnancy. This is sometimes referred to as “abortion pill reversal.”

More information on this process is available through the Abortion Pill Reversal Network. If you’ve already taken the first pill and are having second thoughts, time-sensitive action is needed, so reaching out to a medical provider immediately is important. You can reach our Abortion Pill Reversal Number by calling (757) 580-9944.

Is abortion legal in Virginia?

Yes, abortion is legal in Virginia. Under current Virginia law, abortion is permitted through 26 weeks and 6 days (second trimester). During the first trimester, an abortion can be performed by a licensed physician or a qualified advanced practice registered nurse acting within their scope of practice. 

Abortions should be done in a hospital setting in the second trimester. Third trimester abortions are legal, but have restrictions, dealing with mental and/or physical health of the mother.

There is no mandatory waiting period for adults seeking an abortion in Virginia. However, unemancipated minors (under 18) must obtain written, notarized consent from a parent, legal guardian, or other authorized adult, who must also be notified at least 24 hours before the procedure. 

If you are considering an abortion and would like to understand all of your options, schedule a consultation with us today. We have 5 locations across Virginia so you can find the closest one to you. 

All of our services are free, confidential, and available by same-day appointment.

• Virginia Beach
• Norfolk
• Chesapeake
• Portsmouth
• Suffolk

Call us at (757) 709-6099 or schedule a free appointment online.