A self-managed abortion (SMA) is when a person ends a pregnancy using abortion pills outside of a traditional clinic setting, often with remote guidance from a trained healthcare provider.
The medicines used in a self-managed abortion are primarily mifepristone and misoprostol, which are approved by the FDA for ending early pregnancies and are widely used around the world.
Key Points
- SMA involves using abortion medication at home.
- Most commonly done during the first trimester of pregnancy.
- It is generally more affordable than other abortion procedures.
- Privacy and confidentiality are major benefits of this method.
- Recovery usually takes about 1 to 3 weeks but can vary.
Why Women Choose Self-Managed Abortion
Many South Africans choose self-managed abortion to protect their privacy and overcome barriers within the formal healthcare system. National estimates suggest that 52%–58% of abortions in South Africa take place outside regulated settings.
Avoiding stigma: Some women fear being discovered and judged by their communities, and experiencing stigma or shaming from healthcare workers in public clinics.
Effectiveness: Infact, evidence shows that self-managed medication abortion, when done correctly, can be just as safe and effective as medication abortion done in a clinic.
- Avoiding delays: SMAs are a “short cut” to avoid the lengthy waiting times always at public clinics and administrative long paperwork, mandatory scans, and multiple visits that delay abortion care.
In areas where surgical abortions are limited, the use of abortion pills at home offers a safe and private option. In South Africa, tele-abortion expanded during the 2020 lockdowns, allowing pills to be prescribed remotely and delivered by courier.
Patient Information
Self-managed abortion can be a safe and effective option within the first 12 weeks of pregnancy, when abortion pills are most effective.
However, individuals with certain medical conditions or those taking specific medications may face increased risks and should consult a healthcare professional before proceeding without supervision.
👉 Key Safety Considerations
- Highly effective: When taken correctly and within the recommended timeframe, abortion pills successfully end a pregnancy in most cases without the need for surgical procedures.
- Low risk of complications: Common side effects of abortion pills include cramping, bleeding, nausea, and mild fever. These effects are expected and usually resolve on their own.
- Safer than unsafe methods: Self-managed abortion using approved medications is significantly safer than unregulated or harmful abortion methods.
- Medical support recommended: Although the process can be completed safely at home, access to medical care is important in the event of heavy bleeding or other rare complications.
👉 When It May Be Unsafe
- Pregnancy beyond 12 weeks: Medical abortion becomes less effective and carries higher risks as pregnancy progresses.
- Suspected ectopic pregnancy: Also referred to as tubal pregnancy, it is a medical emergency and cannot be treated with abortion pills.
- Serious health conditions: Individuals with bleeding disorders, severe anemia, or similar conditions may face increased risks.
- Unverified or incorrect use: Using abortion pills from untrusted sources or not following correct instructions increases the likelihood of complications.
How to Prepare for a Self-Managed Abortion
Preparing for a self-managed abortion using abortion pills at home involves gathering the necessary medical and comfort supplies, planning a time and space for privacy and rest, and having a plan in place in case you need medical support.
Safety First!
- Confirm Eligibility: Self managed abortion is generally effective for pregnancies under 11-12 weeks of gestation.
- Medical Restrictions: Do not attempt using abortion pills at home if you have confirmed that its is an ectopic pregnancy or have an IUD in place. (It must be removed first)
Gather Essentials
- Pain Management: Stock up on abdominal pain medication like nurofens for period pains but avoid Aspirin. (It will make you bleed more)
- Hygiene: Use ordinary heavy-flow menstrual pads to monitor bleeding. Do not use tampons in order to reduce the risk of infections.
Hydration and Nutrition: Have easy-to-digest snacks like crackers or soup, and sip electrolyte drinks to stay hydrated if you experience nausea or diarrhea
📌 Discover More:- Self-Abortion Essentials You Need ↗
Self-Managed Abortion Checklist
Choose the Right Time
- Privacy: Find a quiet, private place with a bathroom and, if possible, a friend or family member nearby for support.
- Resting: If possible, plan to rest for 2–3 days after using the abortion pills to support a full recovery.
- Medical Support: Stay in contact with your healthcare provider through the tele‑abortion platform for guidance, check‑ins, and support.
- Bonus Tip: Be aware of local laws. Share only with trusted people and keep your online activity private.
To fully understand the medical abortion process, including what to expect before, during, and after taking abortion pills, see our guide on How Medical Abortion Works ↗
How to use Abortion Pills at Home
Using abortion pills at home involves taking 2 medicines mifepristone and misoprostol. It is important to follow the steps properly, know what to expect, and take good care of yourself afterwards.
Step 1: Swallowing Mifepristone
Swallow one mifepristone pill with water. This pill is meant to stop progesterone the female hormone that supports the pregnancy. Without it the pregnancy can not continue.
- Most women feel fine after swallowing this pill. It’s unlikely, but if you throw up within the first 30 minutes after taking it contact your abortion provider.
Step 2: Using Misoprostol
24 hours later, you can use misoprostol in two different ways, vaginally or sublingually (under your tongue). Both methods are effective, but using them sublingually causes more nausea.
How to take misoprostol sublingually
30 minutes before using misoprostol, swallow ibuprofen to help reduce cramping, and place 1 ondansetron tablet under your tongue to help prevent nausea and vomiting.
Note:- It’s unlikely to vomit but if you do within 30 minutes contact your healthcare provider.
Then After ...
Place 4 misoprostol tablets under your tongue and keep your mouth closed so they stay in place. As the tablets melt swallow. You may also use some water to assist in swallowing.
- This method may cause more nausea because the medication is absorbed quickly under the tongue, which can make the effects start faster and feel stronger.
How to use misoprostol Vaginally
First, go to the bathroom and empty your bladder. (urinate). Then either in a squatting position, lying on your back with your knees bent or standing with one leg up, use your middle index finger to push 4 misoprostol pills, one by one deep into your vagina.
Note:- Do not use lubricants. If needed, you may lightly wet the tablets with a small drop of water to make insertion easier.
It is important to follow the steps properly. For detailed instructions on using abortion pills safely, check out How Abortion Pills Work ↗
What to Expect after Taking Abortion Pills
After taking abortion pills, your body will begin to end the pregnancy. You should expect both physical and emotional changes. For many people, it feels similar to a heavy period with strong cramps, or an early miscarriage.
Physical Changes
- General Effects: You may experience nausea, vomiting, diarrhea, chills or mild fever a few minutes after using the misoprostol pills.
- Cramping and Pains: Strong period pains is normal as the uterus contracts in order to expel the pregnancy.
Bleeding with Clots: Heavy bleeding with clots is normal and usually decreases once the pregnancy has passed.
Emotional Responses
It is normal to experience a range of emotions after terminating a pregnancy. Some people feel relieved, while others may feel sadness, guilt, or regret. These feelings might and go or you might barely think about them over time.
If you feel you need support after your abortion, you can ask your abortion provider for counselling or learn more about coping with emotions on our emotional changes after abortion page ↗
Abortion Recovery: How long does it take?
Recovery after a self-managed abortion varies. Most people feel better in a few days. Cramping and light bleeding can last for days to a couple of weeks. You can also read about how to safely recover after abortion on our recovery page.
How to Confirm a Self-managed Abortion Worked
To confirm if a self-managed abortion was successful in 2026, monitor physical symptoms such as nausea, vomiting, and bleeding patterns. It is advisable to take a home pregnancy test about 3 weeks after completing all medications or once the pregnancy has passed.
Confirming Abortion Success
- Home pregnancy test: Wait at least 3 weeks before testing. A negative result confirms success. If still positive after four weeks, see a healthcare provider. Learn more about testing accuracy here.
- Ultrasound: An ultrasound can confirm if the pregnancy was fully expelled as early as 10 days after the abortion.
- Blood tests: A series of blood tests can confirm success—one before or during treatment and another 5–7 days later.
When Can I Start Family Planning?
After completing a self-managed abortion at home, you can generally start most forms of family planning immediately. Talk to a healthcare provider to choose the method that suits you best, and begin using it as soon as you feel ready to prevent another unplanned pregnancy.
When to Seek Medical Help
Although some people choose to manage the abortion process on their own, often because of access or personal reasons. If you do, it is important to watch your body closely and know when to get medical help. Problems are not common, but they can happen during or after the process.
Seek Medical Attention Immediately If You Notice:
- Heavy bleeding: Soaking through two or more sanitary pads in one hour, for two hours in a row.
- Severe or ongoing pain: Strong stomach or pelvic pain that does not improve after taking over-the-counter pain medicine.
- Fever: A temperature of 38°C (100.4°F) or higher after taking the abortion pills.
- Ongoing sickness: Constant nausea or vomiting that does not stop, which may mean the abortion is not complete.
- Bad-smelling discharge: A strong, foul, or unusual vaginal smell or discharge, which may be a sign of infection and may need treatment.
Additional Resources & Support
After a self-managed abortion, it’s important to take care of your body and well-being.
The guides below provide information on recovery, managing pain, understanding complications, and connecting with confidential support networks.
Helplines
- Carlton Women's Clinic: 083 765 1800
- CTOP National Helpline: 0800 150 150
- LoveLife Counselling Line: 0800 121 900
- LifeLine South Africa: 0861 322 322
- Akeso Mental Health Support Line: 0861 435 787
Guides & Articles
Community Support
Summary
Using abortion pills at home is a common method of self-managed abortion, especially for early pregnancies, and it allows individuals to take an active role in their reproductive healthcare.
With proper information and support, this option allows the pregnancy to be ended safely, privately, and on a timeline that works best for the person involved.
Dr. Nelisiwe Mbele, with the
Carlton Women’s Clinic
Team
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Frequently Asked Questions
How risky are DIY Abortions?
Self-administered abortions carry inherent risks that individuals must carefully consider. For instance potential lack of knowledge regarding essential post-procedure care. This lack of information can lead to misunderstandings about what to expect and how to manage one’s health following the procedure.
How effective are self-managed abortions?
Research indicates that self management of abortion tablets is effective in over 95% of cases when used within the first 10 weeks of pregnancy, contributing to the success of the abortion.
However, it is essential for individuals to have access to accurate information about Mifepristone and Misoprostol tablets and understand the potential risks and side effects to ensure their safety during the process.
When is a self-managed abortion unsafe?
Accordion Content
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- Carlton Women’s Clinic Johannesburg. (n.d.). Surgical Abortion. Retrieved from https://www.womensclinicjohannesburg.co.za/what-you-need-to-know-about-surgical-abortions/
- Cleveland Clinic. (n.d.). Foods to Help Healing. Retrieved from https://health.clevelandclinic.org/foods-to-help-healing
- Life Healthcare. (2023). Post-Surgical Diet Guidance. Retrieved from https://www.lifehealthcare.co.za/media/3773/life-oncology_diet-sheets_diarrhoea_june2023_v4-outlines.pdf
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- Harvard Health Publishing. (n.d.). Proper Hydration. Retrieved from https://www.health.harvard.edu/staying-healthy/how-much-water-should-you-drink
- Carlton Women’s Clinic Johannesburg. (n.d.). Abortion Recovery Tips. Retrieved from https://www.womensclinicjohannesburg.co.za/abortion-recovery-tips/#post-abortion-care
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The physical and hormonal healing period following an abortion, during which the body restores strength, balance, and normal function.
A condition caused by low iron levels, often linked to blood loss, leading to fatigue, weakness, and reduced oxygen transport.
The stabilization of reproductive hormones after pregnancy ends, supporting energy levels, mood, and overall recovery.
A key female hormone that regulates the menstrual cycle and reproductive system, which fluctuates after abortion.
A hormone that supports pregnancy and drops after abortion, triggering physical recovery processes.
The body’s ability to digest and absorb vitamins and minerals needed for healing and energy restoration.
Foods that help reduce inflammation in the body, supporting tissue repair and faster recovery.
A diet rich in protein that supports muscle repair, tissue healing, and immune strength.
The maintenance of essential minerals that regulate hydration, nerve function, and muscle activity.
A measure of how well the body is supplied with fluids, essential for circulation and healing.
The process by which the body rebuilds damaged or stressed tissues following a medical procedure.
Dietary choices that strengthen the immune system and help protect against infection during recovery.
Foods high in iron that help replenish blood levels and reduce post-procedure fatigue.
The process by which vitamin C enhances iron uptake and supports immune and tissue health.
Medical guidance, nutrition, and self-care practices that support safe and complete recovery.
