Abortion pill reversal: what to do if you took the pill and changed your mind

What to do right now

Don't take the second pill if you want to keep the pregnancy. Misoprostol makes the uterus cramp and push out the pregnancy. If you haven't taken it yet, wait and talk to someone first.
Call someone today. Your own doctor, or a pregnancy center near you. In Michigan, see free pregnancy help in Michigan. The Abortion Pill Rescue Network, a group that supports reversal, runs a 24/7 helpline at 1-877-558-0333 and says it connects callers with a medical professional nearby.
Move quickly if you're considering reversal. In the published studies, progesterone was started within 72 hours of the first pill.
Get an ultrasound. It shows whether the pregnancy is still developing. Many pregnancy centers offer one free.
Watch for heavy bleeding (see the warning signs below). Stopping after the first pill can bring heavy bleeding.

What happens if you don't take the second pill

Mifepristone, the first pill, blocks progesterone, the hormone a pregnancy needs to keep growing. Misoprostol, the second, is what makes the uterus empty. The FDA label says misoprostol is meant to be taken 24 to 48 hours after mifepristone.

Without misoprostol, some pregnancies keep going. How many is uncertain, because few people have been studied:

ACOG says up to half of pregnancies continue with mifepristone alone.
A 2023 systematic review pooled the small studies available. At 7 weeks or less, about 22% of pregnancies (roughly 1 in 5) were still continuing with mifepristone alone. At 7 to 8 weeks there were too few cases for a reliable number.
A 2026 study by reversal supporters used a rate of about 25% from earlier research for mifepristone alone.

Two other things are worth knowing:

Bleeding. In a 2020 trial, researchers stopped early after three participants had severe bleeding, two of them in the group that got mifepristone alone. The researchers warned that people who take only mifepristone "may be at high risk of significant hemorrhage."
If the pregnancy continues. The FDA label says the chance of birth defects after mifepristone, if the pregnancy isn't ended, is unknown. Ask your doctor about this and about follow-up ultrasounds.

What abortion pill reversal is

Abortion pill reversal means taking extra progesterone after mifepristone, in the hope of outcompeting the mifepristone so the pregnancy can keep going. In the studies, doctors gave progesterone as pills, as a shot, or as vaginal medicine, over days to weeks. It has to be prescribed by a doctor or other medical professional.

Some doctors offer it, and pregnancy centers can often help you find one. ACOG, the main professional group for U.S. obstetricians, does not support it.

Where researchers disagree

Does abortion pill reversal work?

What supporters cite: case reports and case series since 2012 describing pregnancies that continued after progesterone. The largest, published in 2026 by doctors who support reversal, reviewed 765 women who contacted a reversal hotline and took progesterone. About 55% had a continuing pregnancy two weeks later, which the authors compare with about 25% for mifepristone alone. They reported few serious problems: significant bleeding in 0.3%, emergency room visits in 3% and hospital stays in 0.5%. The study had no comparison group treated at the same time, and birth outcomes weren't known for most of the women.

What ACOG and a 2023 review say: ACOG says claims about reversal are "not based on science." It notes the first case series, in 2012, had six women and no comparison group. A 2023 systematic review in BMJ Sexual & Reproductive Health found, mostly from poor-quality studies, that the rate of continuing pregnancy with progesterone was not significantly higher than with mifepristone alone, and judged the evidence insufficient to recommend it.

The one randomized trial: a 2020 trial led by Mitchell Creinin planned to give 40 women either progesterone or a placebo after mifepristone. It stopped after 12 because of severe bleeding: one case in the progesterone group and two in the placebo group. Of the 10 women who finished, 4 of 5 on progesterone and 2 of 5 on placebo still had a continuing pregnancy, too few to tell whether progesterone helps.

So far, no completed randomized trial has shown that reversal works, and none has settled the question either way.

Warning signs to watch for

Get medical care right away (call 911 or go to an emergency room) if you:

Soak through two or more thick pads an hour for two hours in a row
Have a fever of 100.4°F (38°C) or higher that lasts more than 4 hours
Have stomach pain, or feel sick with weakness, nausea, vomiting or diarrhea. These can be signs of infection even without a fever.

These are the warning signs the FDA lists for the abortion pill. The 2023 review also found that waiting after mifepristone, with or without progesterone, may carry a higher risk of bleeding than finishing with misoprostol, so keep your doctor informed whichever way you go.

If you've already taken both pills

The reversal studies only included people who hadn't taken misoprostol. If you've taken both pills and feel regret, grief or confusion, those feelings are real and you don't have to carry them alone. See what to expect after an abortion, or talk to someone, free and confidential. To understand the process you're going through, see how the abortion pill works.

Sources

ACOG. Medication abortion reversal is not supported by science.
U.S. Food and Drug Administration. Mifeprex prescribing information and Medication Guide (2023).
Creinin MD, et al. Mifepristone antagonization with progesterone to prevent medical abortion: a randomized controlled trial. Obstet Gynecol 2020;135(1):158–165.
Stifani BM, Lavelanet AF. Reversal of medication abortion with progesterone: a systematic review. BMJ Sex Reprod Health, published online 2023; 2024;50(1):43–52.
Delgado G, et al. A retrospective cohort study evaluating the effectiveness and safety of exogenous progesterone for the continuation of pregnancy after exposure to mifepristone. Linacre Quarterly, published online June 2026.
Abortion Pill Rescue Network. abortionpillreversal.com (helpline number, checked November 2, 2026).

Common questions

I took the first abortion pill and changed my mind. What should I do?

If you want to keep the pregnancy, don't take the second pill (misoprostol), and contact a doctor or a pregnancy center right away. Watch for heavy bleeding. Some pregnancies continue after the first pill alone. Find free help near you.

What happens if you take the first abortion pill but not the second?

Some pregnancies continue. ACOG says up to half do; a 2023 research review of the small studies available found about 1 in 5 at 7 weeks or less. Stopping after the first pill can also bring heavy bleeding, so stay in touch with a doctor. The FDA label says the chance of birth defects if the pregnancy continues is unknown.

Does abortion pill reversal work?

It's disputed. Supporters report that more pregnancies continue with progesterone than without it. ACOG and a 2023 systematic review say the evidence is too weak to show it works, and the one randomized trial was stopped early. No completed randomized trial has shown that it works.

How soon do you need to start abortion pill reversal?

In the published studies, progesterone was started no later than 72 hours after mifepristone. If you want to try it, call as soon as you can.

Is there a hotline for abortion pill reversal?

The Abortion Pill Rescue Network, run by supporters of reversal, has a 24/7 helpline at 1-877-558-0333. You can also contact a local pregnancy center or your own doctor.

Last updated 2026-11-02. Medical facts on this page are drawn from the sources listed at the end and on our sources page. This is general information, not medical advice.