Misoprostol-only abortion: Is it ever a good idea to take misoprostol alone?

You may have heard about taking just misoprostol for a medication abortion. Find out how it works and what to know before taking it.

The abortion pill regimen has included two different drugs, for many years now. Even as part of the standard regimen, it has raised safety concerns by doctors, lawmakers and various organizations.

So why are we seeing “misoprostol-only” abortions being advertised lately?

What difference does it actually make if you are thinking about abortion?

Let’s take a look at the reasons for the switch and – more importantly – what you need to know to protect your health.

This post medically reviewed by on-staff nurse, Tomi Matlock, RN.

Note: The information on this website is intended for general education purposes only and should not be relied upon as a substitute for professional medical advice.

Typical medication abortion process

The most common prescription for medication abortion includes mifepristone (Mifeprex or RU-486), followed by misoprostol (Cytotec).

Mifepristone is given to block the production of progesterone, depriving the baby of nutrients it needs to survive.

Misoprostol is then given to cause contractions and expel the deceased baby from the uterus.

Note: Misoprostol is sometimes used in miscarriage care. When it’s used to expel a fetus or embryo that has passed away naturally, it is not considered an abortion, even though the same drug might be used for both purposes.

Both drugs carry risks, even when taken by the usual protocol.

These risks have been greater in recent years as abortion pills have created an at-home abortion market with very little or no medical oversight.

Why misoprostol-only?

It appears that the only reason misoprostol started to be offered by itself for abortion is because abortion providers were worried that mifepristone (the first drug) might not be available at some point.

Mifepristone study raises concerns

A recent study showed that mifepristone is actually 22 times more dangerous than what its makers originally disclosed.

When this came to light, lawmakers began to question why it’s still being offered to women.

There have been ongoing court cases attempting to regulate or take it off the market, particularly through the mail.

What happens when you take misoprostol only?

Many women have reported increased pain when taking just misoprostol to induce an abortion.

This is because your body is trying to interrupt and expel a thriving pregnancy all at once and it can be a huge shock to your system.

Your body will naturally try to protect the growing baby.

You may also have cramping and bleeding for a longer period of time.

General side effects of misoprostol include diarrhea, abdominal pain and nausea.

Things to know about a misoprostol-only abortion

It gets a little complicated – but there’s more you should know about taking misoprostol alone (without mifepristone):

It’s less effective

Providers may prescribe additional doses of misoprostol in order to increase its effectiveness.

Misoprostol alone works only about 78% of the time.

The abortion may take longer

With just misoprostol, the process can take longer, and the pain and bleeding may last longer.

As Christa Brown, BSN, RN notes: “Pain is a primary side effect of any abortion but especially of misoprostol. With repeated dosing of this drug in a ‘misoprostol-only abortion’, the patient faces hours and probable days of misery.” 

This drug carries a Black Box warning

Misoprostol comes with the FDA’s strongest safety alert. This is because:

• If it doesn’t cause an abortion, it can cause birth defects
• There is a chance of uterine rupture (a tear in the uterus typically requiring emergency surgery)

It’s not FDA approved specifically for abortion

Misoprostol was never approved by the FDA as an abortion drug alone.

It was actually a drug used to treat stomach ulcers, and that is the only use it’s approved for by the FDA. When used for abortion, it is considered an “off-label” use.

Thinking critically about misoprostol-only abortion

It can be really hard to read between the lines of research over the last several years on whether it’s safe (for women) to use misoprostol only for the purpose of abortion.

One report, for example, stated that in 12,000 misoprostol abortions, 22% of misoprostol-only abortions required surgical completion.

But then the report goes on to say it’s “safe and effective” for use alone in medication abortion. This is an often-repeated phrase by the abortion industry and those who support it and benefit financially from it.

Which is true? Safe and effective, or unsafe and ineffective? You will have to weigh these risks for yourself.

In our review of the evidence, it does seem like the conclusions often do not match the actual data in studies on misoprostol (and mifepristone).

Alternatives to Abortion

Let’s remember: any type of abortion ends the life of your unborn child. There’s really no way around this truth.

That’s exactly why we offer alternatives that include support to help you through whatever factors might be making you consider abortion.

One last note: Ectopic pregnancy screening is a must

When it comes to overall safety, we always want to point out that one of the biggest risks of any abortion pill taken at home or without an ultrasound is that an ectopic pregnancy might be missed.

Ectopic means the pregnancy is located outside the uterus, usually in the fallopian tube. This is a life-threatening condition for the woman, as the embryo is unable to grow in this location and the fallopian tube can burst.

You can only know for sure your pregnancy is in the uterus by having an ultrasound.

With abortion pills like misoprostol, an ultrasound is often not offered by those who distribute the pills.

In fact, follow up medical care is typically absent, putting you at further risk if you suffer complications.

If you’re in the Mountain Grove, Missouri area, you can contact us for your free ultrasound before taking misoprostol or mifepristone. Or, chat with a nurse using the widget on this screen.

Outside of our area? There’s likely a pregnancy help center near you.

Read next:

Torn Between Abortion and Keeping Baby

Ultrasound Before Abortion: Why it Matters

Took the Abortion Pill- What Happens Now?

Is it Safe to Order the Abortion Pill Online?

What are Plan C Pills?