Abortion with Pills (Medical Abortion)
If you are less than 12 weeks pregnant, you can have an abortion with pills at home. Remember, when counting how many weeks pregnant you are, you must count from the first day of your last period.
Abortion with pills, also known as a medical abortion, has become the most common and preferred method of abortion in countries where abortion is legal. It is also probably the most common method of abortion in Malta as well. Abortion pill providers are known to send at least one abortion pill pack to women in Malta every day.
The two reliable abortion pill providers for women in Malta are Women on Web and Women Help Women. Both are reliable organisations that provide authentic abortion pills and only ask for donations to cover the cost of pills and postage. They will also ask you questions about your pregnancy and your health to make sure it is safe for you to take abortion pills.
Do NOT order abortion pills from unverified sources (see example below). These will often ask for huge sums of money and the quality of the pills cannot be verified.
How to Use Abortion Pills
The abortion pack you receive from Women on Web or Women Help Women will contain one tablet of Mifepristone (highlighted green below), and many (usually 4 to 8) smaller tablets of Misoprostol (highlighted red below).
Mifepristone (also known as Mifegynae, Mifeprex, or RU-486) is a medicine that blocks the pregnancy hormone progesterone. It is usually taken in a tablet of 200mg which is swallowed. Mifepristone helps prepare the uterus for an abortion, and makes the abortion easier. Nausea is a common side effect of Mifepristone. Misoprostol (the second abortion pill) is usually taken 24 hours after Mifepristone. If you vomit after taking Mifepristone, you can still continue the abortion with Misoprostol the next day.
Misoprostol (also known as Cytotec or Misodel) is a medicine of the prostaglandin analogue class that causes the uterus to contract and remove the pregnancy, causing an abortion. Misoprostol tablets are usually of a strength of 200mcg each and are small and hexagonal in shape. Four Misoprostol tablets (800mcg total dose) are placed under the tongue for 30 minutes, where they are absorbed. Do not swallow Misoprostol. Bleeding and cramps usually start within a few minutes to a few hours after taking Misoprostol. If bleeding does not start after three hours of taking Misoprostol, or if you are more than 9 weeks pregnant, you should take a second dose of Misoprostol by placing another four tablets under the tongue for another 30 minutes. If you are feeling sick by that point, you can insert Misoprostol tablets in the vagina instead. However, remember that using abortion pills in Malta is illegal, and if a doctor finds pill residue in your vagina it may raise suspicions.
Here is a summary of how to use abortion pills:
Take Mifepristone 200mg. Swallow the tablet with water. Wait 24 hours.
Place four Misoprostol 200mcg tablets under your tongue for 30 minutes. You can then spit out the remains.
Bleeding should start in a few minutes to a few hours. If there is no bleeding within three hours, take a second dose of Misoprostol by repeating step 2. You may also need to repeat step 2 if you are more than 8 weeks pregnant – refer to the instructions that come with your abortion pill pack. If you are feeling too sick to put Misoprostol in your mouth, you can put it in your vagina instead.
Ideally, you should have someone you trust with you when using abortion pills at home. Do not consume alcohol or sedatives when using abortion pills in case you need to call for help. You should be within 60 minutes of a hospital when using abortion pills, in case you need help. This is not a problem in Malta and Gozo because all parts of these islands are within 60 minutes of a hospital.
Make sure you take out any tampons before taking Misoprostol. You should wear maxi pads during the abortion so that you can have an idea of how much blood is coming out. If you fill four or more maxi pads in two hours, you will need to seek medical help.
This video by Women on Web explains how an abortion with pills is carried out:
How to Order Abortion Pills
Women on Web usually ask for a donation of around 100 Euro. Their shipments usually arrive in one to two weeks and they are considered to be very reliable. To order from Women on Web go to https://www.womenonweb.org/en/i-need-an-abortion and click Start Consultation (see below). You will then be asked to answer questions about your pregnancy and your health. They will ask you to provide an address where you will receive the abortion pills. Once you have completed the online form you will receive an email and be asked to donate. Go to https://www.womenonweb.org/en/donate to donate, and make sure to include your reference number. The abortion pill pack will then be shipped to your address.
If you need help ordering from Women on Web, you have questions on how to use the pills, or your pills have not arrived as planned, you can contact Women on Web by sending them an email on email@example.com.
Women Help Women is the other major reputable organisation that sends abortion pills to Malta. They usually ask for a donation of around 75 Euro. Abortion pills from Women Help Women have in the past taken slightly longer to arrive than those from Women on Web, but Women Help Women have recently improved their shipping times to Malta. The process of ordering from Women Help Women is similar to that of Women on Web. Go to https://consult.womenhelp.org/get-abortion-pills?z_language=en and click Start (see below) to do an online consultation where you will be asked questions about your health and pregnancy. You will then be asked for a donation, and after you pay the abortion pills will be sent to the address you specify.
If you need help ordering from Women Help Women, you have questions on how to use the pills, or your pills have not arrived as planned, you can contact Women Help Women by sending them an email on firstname.lastname@example.org.
If you cannot afford the donation, please tell the organisation you are ordering from and negotiate a price with them. They may still be able to help you even if you cannot pay the full amount. If your pills do not arrive in two weeks, contact the organisation you ordered them from. They may still be able to provide you with an abortion pill kit, even if you are close to the 12 week deadline.
The following table compares the services of Women on Web and Women Help Women:
After using Abortion Pills and Seeking Medical Help
Bleeding and cramps are to be expected after taking the second abortion pill Misoprostol. The bleeding is usually heavier than a typical period and may last from a few days to two weeks. Cramps can be quite strong and Ibuprofen (sold over the counter in Malta and Gozo) can help relieve the pain. It is common to see clots or pieces of tissue with the blood, but it is highly unlikely that you would see a formed fetus.
Around 9 out of 10 of all women who use abortion pills at home will miscarry without the need of medical help. However, it you experience any of the following complications you will need to seek medical help:
Severe blood loss, especially if you start to feel weak
Severe pain that does not respond to pain killers
A smelly vaginal discharge
For more information about possible complications after an abortion, visit the NHS UK website.
If you need help after using abortion pills, you can go to hospital and inform staff that you are having a miscarriage. There is no blood test, or other test, that can differentiate an abortion with pills from a natural miscarriage. You may be asked by doctors whether you have taken abortion pills. Keep in mind that if you disclose having taken abortion pills in Malta, you may be reported to the police. Doctors do not need to know you took abortion pills because any miscarriage is treated along the same the lines, regardless of whether it is natural or caused by abortion pills.
If you still have minor symptoms two weeks after taking abortion pills, and wish to have an ultrasound to make sure everything is alright, you can book a private clinic appointment with a trusted gynaecologist.
There is a small possibility (less than one of twenty cases) of the pregnancy continuing after taking abortion pills. You can confirm whether abortion pills worked by taking a pregnancy test after 2-3 weeks. If it is positive, there is a chance the pregnancy could have continued and you should have an ultrasound to see what is going on. If the pregnancy has continued, you can take another course of Mifepristone or Misoprostol if you are still less than 12 weeks pregnant. Otherwise, you can opt to have a surgical abortion abroad.
You can become pregnant again immediately after an abortion. You can restart your regular contraceptive pill the next day after taking Misoprostol. If you do not start a regular contraceptive pill within 5 days of taking Misoprostol, you should use a condom to avoid getting pregnant.