Medical Termination — Patient Preparation
This page provides general information only — not personal medical advice. Every person's situation is different. Always follow the specific instructions given to you by your doctor, nurse practitioner, or healthcare provider. If you have concerns or questions, contact your provider directly.
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Medical Termination of Pregnancy — What to Expect
A preparation guide for people who have already made a decision with their healthcare provider and are planning to take MS-2 Step (mifepristone and misoprostol) in Australia.
🇦🇺 Australia
RANZCOG guidelines
Healthdirect
What is MS-2 Step?
MS-2 Step is the name of the medicine used for medical termination of pregnancy in Australia. It contains two medicines — mifepristone and misoprostol — taken in two steps, 36 to 48 hours apart.
It is approved in Australia for medical termination up to 63 days (9 weeks) from the first day of your last period. It is listed on the PBS, meaning Medicare covers part of the cost.
MS-2 Step can be prescribed by a GP, and in some states also by a nurse practitioner or endorsed midwife. It can be dispensed at any pharmacy with a prescription. It can be taken at home or in a clinical setting — your provider will advise which is appropriate for you.
📋 The two steps — what happens
Step 1 — Day 1
Mifepristone 200mg (green tablet) — swallow with water
• Take on an empty stomach — 2 hours before or after eating
• Avoid grapefruit juice around this time
• You can usually continue normal activities after taking this tablet
• Some light spotting or bleeding may start 1–2 days after this tablet
Step 2 — 36–48 hours later
Misoprostol 4 tablets — buccal route (held in cheek)
• Place all 4 tablets between your cheek and gum (2 each side, or all on one side)
• Hold in place for 30 minutes — do not swallow them during this time
• After 30 minutes, swallow any remaining fragments with water
• Take on an empty stomach — 2 hours before or after eating
• Take your pain relief 30 minutes before the misoprostol (as advised by your provider)
• Stay home and rest for at least 3–4 hours after taking misoprostol
• Bleeding usually starts 30 minutes to 2 hours after the misoprostol and may be heavy for up to 6 hours
What to expect — bleeding and pain
Bleeding is the main sign the process is working. It will usually be heavier than a normal period and may include clots and tissue. Heavy bleeding typically peaks in the first few hours after misoprostol and then gradually reduces. Lighter bleeding or spotting may continue for 1–3 weeks.
Pain (cramping) is common and can be significant — similar to strong period pain or more intense. Take pain relief as advised by your provider. Ibuprofen is commonly recommended if you can take it.
Other common effects after misoprostol: nausea, vomiting, diarrhoea, chills, or low-grade fever. These usually settle within a few hours. Your provider may prescribe anti-nausea medication — take it as directed.
Having a support person at home is strongly recommended on the day you take misoprostol. You should not be alone for at least 3–4 hours.
🚨 When to seek urgent help
Go to your nearest emergency department or call 000 if you experience:
❌ Soaking through more than 2 thick pads per hour for 2 or more hours in a row
❌ Severe pain that is not relieved by pain medication
❌ Signs of infection: fever above 38°C lasting more than 24 hours, foul-smelling discharge, increasing abdominal pain after the first 24 hours
❌ Feeling faint, dizzy, or that you may pass out
❌ No bleeding at all within 24 hours of taking misoprostol
Also contact your provider if: You are concerned at any point, you are unsure whether the process is complete, or you develop any new symptoms that worry you. Your provider should have given you an after-hours contact number — use it.
🧪 STI testing — your GP may offer this
Australian guidelines recommend that your GP or clinic offers STI testing as part of pre-termination care. This typically includes a swab or urine test for chlamydia and gonorrhoea, and sometimes a blood test for HIV, hepatitis B, and syphilis.
Your GP or clinic will discuss whether STI testing is appropriate for you as part of your care.
If a STI is found, your GP will discuss treatment with you. Treatment does not necessarily delay the procedure — your GP will advise based on your specific situation.
Always follow the specific advice of your own doctor or healthcare provider — this page provides general information only.
Follow-up care
A follow-up appointment is recommended 14–21 days after taking mifepristone. This usually involves a urine or blood pregnancy test to confirm the termination is complete. Clinical history alone cannot reliably confirm this.
In a small number of cases (2–5%), MS-2 Step may not fully work. If this occurs, your provider will discuss options including a repeat dose of misoprostol or a surgical procedure.
📞 Support services
1800 MY OPTIONS — 1800 696 784 — free pregnancy options counselling (VIC)
Children by Choice — 07 3357 5011 — counselling and information (QLD)
MSI Australia — 1300 003 707 — appointments and information (national)
Family Planning Australia — 1300 372 372 — information and referrals
Lifeline — 13 11 14 — 24-hour crisis support
Counselling is not mandatory and is entirely your choice. Services are confidential.