- Virginia Women’s Wellness
What Does an Abortion Really Feel Like? An Honest Answer
It depends on the method you choose. Abortion pills cause a miscarriage that feels like a very heavy, crampy period, strongest for several hours and lasting for up to days. An in-clinic procedure while awake brings intense pain for a few minutes; with twilight sedation most women feel very little; fully asleep, you feel nothing. Afterward, most women feel cramps like a period for a day or two — and, most often, relief.
Key Facts
- Abortion pill : Strong cramping and heavy bleeding with clots, mostly over 4–6 hours but sometimes lasting for days; often nausea, chills, or diarrhea
- Procedure, awake : Intense cramping and pain, strongest for a minute or two; lasting in total for about 10 minutes in the first trimester
- Procedure, twilight : Relaxed and drowsy; little or nothing felt, memories hazy or fuzzy
- Procedure, asleep : Nothing felt or remembered; you wake up in recovery
- Afterward : Period-like cramps for a day or two; bleeding for days (procedure) to 1–2 weeks (pill)
- Emotions : Relief is the most common feeling; sadness or mixed feelings are normal too
- Your choice : Awake, twilight, fully asleep, or pills — you choose
Many women tell us that what they feared most was not knowing what it would feel like. So here is the honest answer, from clinicians who have cared for more than 100,000 women — not the worst-case version, and not a sugar-coated one.
What does the abortion pill feel like?
- After the first pill (mifepristone): most women feel little or nothing. Some have light bleeding or mild nausea. Many go about their day.
- After the second medicine (misoprostol): within about 1 to 4 hours, strong cramping and bleeding begin. The cramping builds — for many women it feels like very strong period cramps; for some it’s stronger, coming in waves like labor. This is not a period – you are having an early miscarriage. The bleeding is heavier than a period, with clots, some as large as a lemon. This is the part most women describe as hardest, and it’s usually heaviest for several hours, while the pregnancy passes. After the pregnancy passes, the cramping and bleeding subside, but don’t go away, and can last for several days.
- Side effects of misoprostol often include nausea, vomiting, diarrhea, chills, or a brief fever on that day. They pass naturally after the first day of misoprostol.
- What helps: taking ibuprofen before the cramping starts, a heating pad, lying down or moving around — whatever feels better — and having someone you trust with you or nearby.
- What you may see: most women pass the pregnancy in the toilet and will see just large blood clots. If you don’t examine the clots that may be all that you see. If you want to look at it, early in pregnancy, before 9 weeks, you will not see the pregnancy, it just looks like a heavy period with clots. Later in the first trimester, you may see a small sac with tissue. Later in the first trimester, the pregnancy is a little more advanced, and the experience is more intense. It is still a miscarriage – but a later miscarriage.
- Afterward: the bleeding slows to a period-like flow and then spotting, on and off for one to two weeks. Cramping eases within a day.
What does an in-clinic procedure feel like?
It depends almost entirely on the anesthesia you choose. Anesthesia and Asleep Abortion
- Awake with local numbing. You’ll feel the speculum, like a pelvic exam. The numbing injections at the cervix may feel like a series of small pinches or cramps. While the cervix is opened and during the suction, most women feel pressure and strong cramping — usually the most intense part, lasting a minute or two. This is what the numbing helps with. It numbs your cervix, but not the body of your uterus. You’ll hear the gentle sound of the suction. You will feel scraping and pulling and cramping inside your uterus. It is painful – sometimes intensely painful - but the whole procedure only takes about 10 minutes in the first trimester, and a member of our team stays with you, talking you through each step. Cramping eases quickly once it’s done.
- Twilight sedation. You’ll feel the small pinch of the IV, then a warm, relaxed, drowsy feeling. You may drift in and out. Most women feel or remember very little during the procedure or after. Some report that their memory of the procedure is “blurry” or “fuzzy”. One woman reported “I vaguely remember the procedure. I can sort of remember them working on me down there. I felt something, but it didn’t bother me.”
- Fully asleep. You’ll feel the IV, then fall asleep within a minute or so. Most women tell us the next thing they remember is waking up in recovery, a little sleepy, with it over.
- Afterward: most women have cramps like a period for a day or two, and light bleeding for a few days to a couple of weeks. If you had sedation, you may feel sleepy or a little unsteady for the rest of the day. Some women have pleasant visual hallucinations afterwards and remember those. For example, one woman in the recovery room reported “I was smoothly sailing through the air – in a sailboat - in heaven. The doctor and I had gone fishing.” Another reported “I was floating – in the fields – with the flowers.”
How painful is an abortion, compared with what I’m afraid of?
For most women, less than they feared — but we won’t promise it’s painless, because the honest answer depends on what you choose:
- If feeling nothing is what matters most to you, choose an in-clinic procedure and be fully asleep.
- If you want to be comfortable but not fully asleep, choose twilight sedation.
- If you’d rather avoid a procedure and are willing to manage strong cramps at home for several hours, choose the pill.
- If you want to be alert and go home soonest, choose an awake procedure; the hardest part lasts a minute or two.
How will I feel emotionally?
There is no right way to feel. In the largest long-term study of women who had abortions in the United States, the most common emotion afterward was relief, and five years later, about 95 percent said it had been the right decision for them. Some women also feel sadness, grief, or a mix of feelings, sometimes alongside the relief. All of these are normal, and they usually ease with time. If you feel persistently low, anxious, or unable to manage day to day, tell us or your own doctor. You don’t have to handle it alo
What helps: someone you trust to talk to, rest, and permission to feel whatever you feel. Our counselors are here before and after your abortion, and free confidential talk lines are available if you’d like to speak with someone outside our office, such as Exhale, a nonjudgemental after-abortion support line. Their phone number is 617-749-2948.
When does what I feel mean that I should call?
Call us right away if you have:
- Bleeding that soaks through five pads an hour for two hours in a row
- Severe pain that the pain medicine doesn’t help.
- A fever over 100.4°F that lasts more than a day, or that starts more than a day after misoprostol.
- Feeling very sick, weak, dizzy, or faint
Why women choose Virginia Women’s Wellness for their comfort.
- Your choice of awake, twilight, fully asleep, or the pill.
- Asleep through 27 weeks and 6 days — later than any other clinic in our area.
- Someone by your side: a friend or family member for much of your visit, and a doula if you’d like one.
- Kind, nonjudgmental, all-female care, before, during, and after.
- FAQ’s
Questions Women Ask
Does the abortion pill hurt more than a procedure?
Often, yes, in the sense that the cramping lasts longer — several hours or days, rather than a few minutes. With a procedure under sedation or asleep, most women feel little or nothing. But the pill lets you be at home, which many women prefer.
Is it normal to cry afterward?
Yes. Tears can come from relief, from sadness, from the sedation wearing off, or from all of it at once. All of it is normal.
Will I be able to go to work the next day?
Most women can return to normal activities the next day after a procedure, and within a day or two after the pill. However, we ask women to avoid heavy lifting (nothing over 20 pounds) for the first week after the abortion.
Can someone be with me?
Yes. A friend or family member can be with you for much of your visit, and with the pill, we recommend having someone with you or nearby for the first several hours. We also offer trained Abortion Doula services to support you.
Partners, Friends, and Family Members | Abortion Doula Services
Don’t Wait — Call 757-540-1595 or Book Online Now.
Women in Virginia can also Start a Telehealth Visit.
Reviewed by the Virginia Women’s Wellness clinical team board-certified physicians and licensed advanced practice clinicians providing abortion care since 1997. Last updated October 20, 2026
Sources
ACOG Practice Bulletin No. 225; NAF Clinical Policy Guidelines (current edition); Rocca CH et al., “Emotions and decision rightness over five years following an abortion,” Social Science & Medicine 248:112704 (2020) (Turnaway Study).
This page is educational and is not a substitute for individual medical advice.