From what I understand, the cramping and bleeding usually starts within 24-hours of taking the cytotec. However, sometimes it takes longer than that. For those who haven't started bleeding within the 24-hour normal timeframe, it usually does on the second dose of the pills.
If you don't abort the fetus on the first round with the pills, you will be able to tell via ultrasound. Most abortion providers will give you a second round of pills to see if your body will expel the fetus and sac. However, if the third round of pills do not work, you will likely have to undergo a suction abortion, which is always a chance you face when trying to do a medical abortion.
Make sure you pay attention to any cramping or excessive bleeding you might have and make sure to attend your follow-up appointment, because if not, it could wind up causing you to retain fetal tissue and developing an infection.
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