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Abortion Pill in Singapore
In Singapore, women with unplanned pregnancies may opt for a medical abortion, also commonly referred to as “the abortion pill.”
This is a two-medication regimen and offers a less invasive and more affordable option compared to surgical abortion. This article provides essential information on the abortion pill and addresses frequently asked questions about the abortion pill.
The Abortion Pill is a Medically Supervised Procedure
The abortion pill is not an over-the-counter option in Singapore. A face-to-face consultation with an abortion specialist is mandatory to confirm the presence of a viable intrauterine pregnancy, its gestational age and also to assess a patient’s suitability for the abortion pill.
This process includes:
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A comprehensive medical history is used to establish a patient’s suitability for medical abortion. For example, patients with previous uterine surgery, including caesarean sections, may need closer supervision for the abortion pill.
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A pelvic ultrasound to determine the location of the pregnancy, its gestational age and viability. Only pregnancies which are located in the womb and are less than 10 weeks old would be suitable for the abortion pill.
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Abortion counselling by an MOH-accredited counsellor. This is followed by a mandatory 48-hour cooling-off period. Informed consent can then be taken. The abortion pill can only be used after all the above are completed.
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The abortion pill (also known as RU486 or mifepristone) must be taken in the clinic premises and witnessed by the abortion specialist. Subsequent abortion pills (misoprostol) can be taken in the patient’s preferred location, as instructed by the abortion specialist.
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Patients are advised on the red flag signs such as severe pain which does not respond to pain killers, heavy bleeding resulting in dizziness and shortness of breath, fever and offensive-smelling vaginal discharge.
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A follow-up consultation and ultrasound scan are performed one to two weeks after the completion of the abortion pills. This is to ensure that the abortion is complete.
At Daniel Koh Clinic, our abortion pill protocols are based on up-to-date and evidence-based guidelines, so as to optimise success rate and ensure patients’ safety.
How Do Abortion Pills Work?
Before mifepristone was introduced, the misoprostol-only regimen had a failure rate of up to 22% and frequently led to emergency department visits.
Following the 2018 research study by Tan et al (where Dr Daniel Koh is a co-investigator and co-author) on outpatient medical abortion with mifepristone and misoprostol in Singapore’s setting, most abortion practitioners in Singapore adopted the two-medication protocol as a standard of care.
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The First Abortion Pill (Mifepristone) is also known as RU-486. It is available only in licensed hospitals and abortion clinics. Patients are instructed to take between one and three tablets in the abortion clinic under the supervision of an abortion specialist. Mifepristone works by blocking progesterone and softening the cervix to allow the womb to expel the fetus. Most abortion specialists allow an interval of 24 to 36 hours before commencing the second abortion medication (Misoprostol).
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The Second Abortion Pill (Misoprostol) is usually taken 24 to 36 hours after Mifepristone. The tablets can be taken orally or inserted vaginally. Misoprostol causes the uterus to contract and expel the fetal sac. It causes pelvic cramps and heavy bleeding with blood clots. These symptoms start as quickly as 20 minutes from ingestion of Misoprostol and can last up to six hours. Other common side effects include transient fever, chills and rigours, nausea and vomiting and diarrhoea.
The Abortion Pill Process
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First Consultation & Viability Scan
Your abortion specialist takes a comprehensive medical history and performs an ultrasound scan.
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Abortion Counselling & MOH Consent
Your abortion counsellor performs a mandatory counselling session and completes the required documentation. This includes watching a 10-minute-long video which covers the process of abortion, its associated risks and complications and contraception planning. After this session, you have to observe a 48-hour cooling-off period. You can return to the clinic to give your written consent if you subsequently decide to proceed with an abortion.
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Taking the First Abortion Pill (Mifepristone)
Mifepristone is taken in the clinic under an abortion specialist's supervision.
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Taking the Second Abortion Pill (Misoprostol)
At least 24 hours later, you can take four misoprostol tablets, either orally or vaginally. Protocols may vary between clinics.
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Monitoring Symptoms at Home
You will usually be given a course of antibiotics, painkillers and medications to address the potential side effects of the abortion pills. You will also be advised on when to seek medical assistance.
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Follow-Up Review
You will be given a follow-up appointment to ensure that the abortion is successful.
What Is the Cost of Abortion Pills in Singapore?
A course of mifepristone and misoprostol costs around $500, and this does not include medical consultations, ultrasound scans, abortion counselling and other essential medications.
Are Abortion Pills Legal in Singapore?
Abortion may ONLY be performed if the woman meets the following criteria:
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The woman is a Singapore citizen or the wife of a Singapore citizen.
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The woman holds a valid work pass under the Employment of Foreign Manpower Act, or is the wife of such a holder.
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The woman has resided in Singapore for at least four consecutive months immediately before the procedure.
These requirements are waived ONLY if the treatment is immediately necessary to save the woman’s life.
Although abortion can be performed for pregnancies up to 24 weeks old, the majority of the public hospitals and private clinics in Singapore restrict the option of the abortion pill to pregnancies up to 70 days old. The age of a pregnancy is determined by measuring the length of the fetus on an ultrasound scan.
Who Is Suitable for the Abortion Pill?
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The pregnancy is less than 70 days of gestational age.
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You can return for follow-up consultations and access emergency care quickly if needed.
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You have no medical contraindications to mifepristone or misoprostol (see the next section for details).
If you are unsure whether you meet these criteria, book a consultation with Dr Daniel Koh. He will review your situation and advise you on the most appropriate option.
Who Is Not Suitable for the Abortion Pill?
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Previous Uterine Surgery: Women who have had surgeries on their womb may be advised against medical abortion due to the risk of uterine scar rupture.
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Ectopic Pregnancy: If the pregnancy occurs outside the womb, the abortion pills will not work and may delay appropriate treatment.
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Pregnancy beyond 10 weeks of gestation: The risk of treatment failure increases with increasing gestational age.
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Serious medical conditions: Women with unstable health issues, such as poorly controlled heart disease, severe liver or kidney impairment, are often advised to consider alternatives such as surgical abortion.
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Certain medications: Women on long-term medication that increases bleeding risks, such as anticoagulants, may also be advised to consider a surgical approach instead of the abortion pill.
What to Expect During and After Taking the Abortion Pill
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Most women do not experience significant pain or bleeding after taking mifepristone.
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About taking misoprostol, you may experience severe abdominal cramps, heavy bleeding and passing out blood clots. These symptoms usually start as early as 20 minutes after taking misoprostol.
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The bleeding and cramping can last for several hours and can be managed with medications.
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Rest at home and stay hydrated until the heavy bleeding subsides.
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Seek help if you soak more than two pads within an hour for two consecutive hours, develop a fever above 38°C, OR have severe pain unrelieved by medications.
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Other side effects, such as fatigue, nausea, diarrhoea, chills, or mild fever, will usually settle within a day.
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Light bleeding or spotting may continue for weeks to months.
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You may resume light activities once you feel better. However, you should avoid swimming, sexual intercourse, and the use of tampons until further advice from your abortion specialist.
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Attend the follow-up appointment even if you feel fine.
If you are unsure whether you meet these criteria, book a consultation with Dr Daniel Koh. He will review your situation and advise you on the most appropriate option.
Medical Abortion vs Surgical Abortion: Which is Better?
There is no “better” method, only the option that suits you. For more information on medical versus surgical abortion, please read our previous blog article.
Below is a table for comparing the two methods:
About Dr Daniel Koh
Dr Daniel Koh
Consultant Obstetrician & Gynaecologist
BMBS (AUS), M.MED (O&G, SG), FRCOG (UK), FAMS (SG)
Dr Daniel Koh is a highly respected obstetrician and gynaecologist based at Gleneagles Medical Centre, with extensive experience in both medical and surgical termination of pregnancy (TOP) in Singapore.
He is a Ministry of Health-accredited abortion provider and counsellor, known for his commitment to evidence-based care, patient autonomy, and confidentiality. Dr Koh provides clear, non-judgmental guidance to individuals navigating unplanned pregnancies, ensuring that every patient is fully informed and supported throughout the process.
His clinical interest in abortion care is backed by published research and protocol development in Singapore. Dr Koh has contributed to studies evaluating the safety and effectiveness of medical abortion regimens, including the outpatient use of mifepristone and misoprostol up to 70 days of gestation.
Selected research contributions include:
With almost two decades of clinical experience, Dr Koh continues to advocate for patient-centred reproductive healthcare within a regulated and compassionate framework.
Your Safety, Privacy & Well-Being Come First
Singapore law requires strict confidentiality for all abortion care. Abortion specialists, nurses and clinics may share details only with your explicit written consent.
Every consultation, scan and follow-up at our clinic follows Ministry of Health guidelines, and your records are protected under the Private Hospitals and Medical Clinics Act. Only authorised clinical staff can access them.
Frequently Asked Questions
Below you will find answers to common questions about abortion in Singapore.
