What to expect at carafem: At Home Abortion Pills

The pandemic (and 2020 in general) is impacting many of us in different ways, but it’s probably safe to say, times are changing and people are doing their best to adapt to the new “virtual” norm. Whether it’s sending a child to school or meeting with a healthcare provider, more people than ever before are figuring out how to carry on with their lives over video. And if you’re like most people, you might not know what to expect from a telehealth appointment — let alone one about abortion care. So we thought it would help to spell out exactly what you can expect when choosing carafem for an at-home abortion. 

Rest assured, you’ll have the same quality of care and take the same medication you’d receive at an in-person appointment — the only difference is that you’ll meet with your provider by smartphone, tablet, or computer. BTW, this is a great option if you are a busy parent, live far away from a clinic, or if you just prefer to stay home.  

Step 1: Take a pregnancy test 

You know your body better than anyone, so when you first experience pregnancy symptoms, it’s a really good idea to confirm if you are pregnant by taking an at-home pregnancy test. The sooner you know, the more options you have, and more time to plan for logistics like taking off of work, finding child care if you’re a parent, etc. 

Most over the counter pregnancy tests work best if you use them first thing in the morning, which is when your urine is most concentrated. The tests are looking for the presence of hCG, a hormone produced during the onset of pregnancy. For the best results, we recommend waiting 7 days after your missed period.

Don’t forget: home pregnancy tests may not work if they are expired, or if you don’t follow the instructions. Before you take your test, check the expiration date and make sure you understand and follow the instructions. Get even more info about this handy at-home tool here

Step 2: Decide if Medically Supported At-Home Abortion Pills are right for you

If you are like many people, you may not learn about your options for abortion care until you need care. In the first 12 weeks of pregnancy, you have options when it comes to your abortion care, and you can decide what type of care is best for you: an in-office procedure or the abortion pill. If you are further than 11 weeks, and/or if you want to go to a health center and leave no longer pregnant, the in-office procedure could be right for you. The procedure, (sometimes called ” MVA,” “aspiration abortion,” or “surgical abortion”) is a safe and simple method of ending a pregnancy in our office with a gentle and quiet hand-held suction device. It has an all-inclusive cost between $550-700 and may be covered by insurance or Medicaid, depending on where you live and your policy.  

The abortion pill has been growing in popularity in recent times, with over 50% of pregnant people who choose abortion in the United States, choosing the abortion pill, according to the Guttmacher Institute’s 2020 data. The abortion pill, also known as medication abortion, is a series of pills that cause cramping and bleeding from the vagina, resulting in the pregnancy leaving the body, similar to a miscarriage. It is incredibly safe and effective and has been used by trusted medical providers in the US for over 20 years. Many people decide this is right for them because they appreciate the ability to take the pills and end their pregnancy in the privacy of their home. If you decide this is your method of choice, you then can decide if you want to come to a carafem health center or meet with a provider over secure video from your home. The abortion pill costs between $250-600, depending on where you live, what regimen you select, and if you choose an at-home or an in-center option. Abortion pill visits in the health center may be covered by insurance or Medicaid. Financial assistance may be available to those who qualify. You can discuss your eligibility during your video visit. 

First, be aware that you need to have an address in a state where telehealth abortion care is legal. Unfortunately, although taking the abortion pill at home is incredibly safe and effective, each state can make its own laws about accessibility via telehealth. carafem is working to expand telehealth abortion care to all allowable states, but for now, carafem clients must have a mailing address in Colorado, Connecticut, Delaware, the District of Columbia, Illinois, Iowa, Maine, Massachusetts, Maryland, Minnesota, Nevada, New Jersey, New Mexico, Rhode Island, Vermont, and Virginia. For those outside of these states, check TelAbortion.org for a list of local resources. 

Keep in mind that you may need to obtain additional testing in your community if you previously have had an ectopic pregnancy, irregular periods, or pelvic pain or inflammation. You may not qualify for the abortion pill if you have an IUD place. Don’t worry though — just give us a call at 1-855-SAY-CARA and we’ll help you find the right place to obtain testing or remove your IUD.

Iowa residents: Please obtain a dating ultrasound in your community. Here is a map of verified ultrasound providers.

Step 3: Make your appointment with ease and at a time that works for you

Ready to make an appointment? Great! The video visit will only take about 30 minutes or so depending on your questions and needs. Scheduling an appointment with carafem is easy — all you need to do is either visit our website at carafem.org or give us a call at 1-855-SAY-CARA. Whether you schedule your visit online or over the phone, we’ll double-check your medical history and make sure at-home abortion pills are right for you.

Step 4: Check your email 

Before your appointment, you will receive an email with instructions on how to join the video call so be sure to provide an email you can access and a phone number we can contact you at as a back-up when you schedule your appointment. 

Step 5: Chat with a kind, compassionate, non-judgemental provider over video   

First, get comfortable and don’t think twice about being on video. The number one trait of carafem’s team members is that we’re non-judgemental, so don’t worry about a messy background, messy hair, or what you are wearing. You do you. This is your time to be comfortable. Don’t even change out of your pajamas if you don’t feel like it!

Once you are comfortable, at the time of your appointment, click the link from the email we sent to join the secure video call. Your abortion care video visit will be on a secure, HIPAA-compliant video chat system that was designed for telehealth care, and can be accessed through a smartphone, tablet, or computer. You will first meet with a carafem care coordinator who will help guide you through the abortion process. They will review your options, talk with you about your choices, and help to be sure you get your initial questions answered. Our care coordinators are experts in providing easy to understand information and options, so you will learn what to expect each step of the way of your abortion visit at home. You will also receive a plan for follow up care and be able to discuss your future contraception needs. You will also electronically sign some consent forms and pay for your visit.

At this point, your clinician will join your video visit. They will ask you about your medical history, discuss your options for the medical regimen, explain how to use the medications of your choice, and review all of the risks and benefits of your chosen care plan. You’ll be able to ask any questions and even be prescribed a birth control method of your choice if you’re interested. At the end of your visit, if you qualify for care, your clinician will electronically order your medications to be sent to you.

There are no visual examinations and a referral for a pelvic exam or ultrasound is usually not medically necessary, so rest assured you don’t need to get in an uncomfortable gown or remove any clothing during an abortion care video visit. It’s simply a discussion about your medical history, confirming your pregnancy, and deciding on a plan of action for your care. 

Step 6: Abortion pills arrive in a discreet package within 1 – 3 business days

After completing the video visit, we will ship the abortion pills directly to the address you provide in discreet packaging. Just like ordering shoes from your favorite online store, you will receive tracking information when your medication ships so you’ll know exactly what day your package will arrive. And because providing compassionate, convenient abortion care is kinda our thing, we’re including some extra goodies along with the care instructions and medications, like a heating pad to help with cramping, and tea and mints to settle an upset stomach. And just so you know, our standard shipping (included in your cost) takes approximately 1-3 business days. When medically necessary, it can be expedited for a small fee. If you live near one of our health centers, you can choose to swing by to pick up your medication in person if you prefer.

Step 7: Take medications according to your plan 

When you met with your provider, together, you made decisions about how and when to take each medication and you should follow your plan when your medication arrives. Throughout the process, you will have one-on-one follow-ups with your care coordinator and carafem staff available to you via a 24/7 phone number. If you’re curious about what to expect when taking the abortion pill — don’t worry, we got you. You can find instructions for taking the abortion pills at home here and learn what to expect after taking the abortion pill here

A few days after your abortion, your care coordinator will contact you for a follow-up call to see how the abortion pills worked for you. Self-care is important, especially after an abortion — so we put together some tips for how to care for yourself, a close friend, or a partner after an abortion. An abortion with medication is very safe, effective, and rarely has complications. To be sure the abortion is complete, your care coordinator will ask you to take a urine-based pregnancy test about 4 weeks after you take the abortion pill to confirm your abortion is complete. 

To date, carafem has provided medication abortion pills through the mail to hundreds of satisfied clients in numerous states. If you’d like to schedule your initial phone call for an At Home Abortion Pill appointment, click here or call 1-855-SAY-CARA.