Post-Abortion Care: Understanding Expected Symptoms & Potential Concerns

Question
Yesterday I was given Mifeprex orally and then 8 hours later took 800mcg of misoprostol vaginally. I was told I should experience cramping and bleeding after taking the misoprostol, but I have yet to experience either. It has been almost 16 hours since the dose of misoprostol and at least 25 hours since the initial dose of mifeprex. I am concerned that the medication may not be working. The initial dose was taken in the clinic and the misoprostol prescription filled though a naytional pharmacy retail store, so the quality of the medicine is not in question.

According to the ultrasound taken the day before the medical abortion (there is a 24 hour waiting period in the state in which I live), I was six weeks along yesterday

Answer
You need to contact the facility and have a repeat dose of Misoprostol.  In 95% of cases the medication works.  However, some patients may not respond to the first dose and need a second dose if there is no bleeding.  We give our patients a second dose just in case this happens.