Can you safely use misoprostol alone for medical termination of pregnancy? Here’s what experts say.

A battle is brewing over mifepristone — a drug prescribed in combination with misoprostol for medical abortions, which now account for more than half of all abortions performed in the United States

In short: Anti-abortion advocates filed a lawsuit against the Food and Drug Administration (FDA) in Texas to overturn FDA approval of mifepristone and ban the drug statewide, even though the drug has been approved for 23 years and one longtime safety record. Meanwhile, 12 states, including Washington, Arizona, Vermont, and Oregon, are suing the FDA with the opposite goal: getting the agency to lift some restrictions on mifepristone that the American College of Obstetricians and Gynecologists called “obsolete” and “essentially.” means restricting access to this safe, effective drug.”

Given concerns about a possible ban on mifepristone, Supporters of abortion rights and have doctors brought to social media to talk about a possible backup plan — namely, taking misoprostol alone for medical abortions.

But how effective is taking only half the standard two-drug regimen for an abortion? And how safe is it? Here’s what experts have to say.

How effective is taking misoprostol alone for medical abortion?

Experts agree that the most effective regimen for medical abortion is a combination of mifepristone and misoprostol. Women’s Health Expert Dr. However, Jennifer Wider tells Yahoo Life that the World Health Organization “lists two safe and effective medical methods for terminating a pregnancy – one of which is misoprostol alone.”

dr Andrea Henkel, a gynecologist at Stanford Medicine Children’s Health and a Fellow in Complex Family Planning at Stanford University, agrees that taking both drugs is “significantly more effective than misoprostol-only therapies for treating first-trimester abortions.” She tells Yahoo Life that with mifepristone and misoprostol, about 1 in 20 people will need a procedure (such as a surgical abortion) to complete the abortion. “Whereas with misoprostol alone, the number is closer to 2 to 3 in 20 people who need a procedure,” she says. “It’s important to remember that many people choose to have a medical abortion because they want to avoid a procedure or because they live far from a clinician who offers procedures.”

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However, misoprostol alone is considered “a safe, reliable, and effective way to perform an abortion,” says Dr. Sheila Attaie, a primary care physician in California and associate of Physicians for Reproductive Health, told Yahoo Life. “Studies show that the success rate is about 80 to 100 percent, depending on the dose and amount of misoprostol taken and how far along a pregnancy is.”

Attaie points to studies that found misoprostol alone was 93% successful in terminating pregnancies up to 10 weeks, while other research states that misoprostol taken alone is “effective and safe” and “a reasonable option for women.” who are seeking a first trimester abortion.”

Misoprostol causes the uterus to contract, bleed, and expel the embryo, according to the Cleveland Clinic, while mifepristone blocks progesterone from further supporting the pregnancy. When you combine the two drugs, “the patient has a higher chance of getting through the pregnancy on fewer doses of misoprostol,” Attaie explains. “Therefore, mifepristone is important but not necessary to have a safe medical abortion.”

How safe is misoprostol?

Attaie says misoprostol is “extremely safe.” She points out that many people — and pets — take the drug to prevent stomach ulcers by reducing the amount of stomach acid. “The complication rate is less than one percent,” says Attaie. “That means it’s safer than taking Tylenol or Advil.”

The most common side effects of misoprostol are nausea, diarrhea, fever and chills. “Misoprostol can make you feel like you have the flu or some COVID symptoms,” Attaie says. “These don’t always happen, but if they do, they should only last a few hours.”

The drug also causes abdominal cramps, “which deflate the uterus and control bleeding, but can be uncomfortable,” she says.

However, as Henkel points out, “When mifepristone becomes unavailable, misoprostol-only regimens require multiple doses of misoprostol, increasing the incidence of these benign but highly uncomfortable side effects.”

If mifepristone is not available, is misoprostol the next best option for medical abortion?

Yes, say experts. “At the population level, if mifepristone is withdrawn from the market, repeated doses of misoprostol will be the most accessible drug for first-trimester abortion,” says Henkel.

However, that doesn’t mean there won’t be barriers. Wider notes that many abortion rights advocates are “incredibly concerned about this pending judgment,” adding, “If this drug is banned, it will definitely limit access to safe and effective medical abortion treatment.”

However, experts say misoprostol alone is a viable option when mifepristone is unavailable. “Many people around the world have used and will continue to use misoprostol to perform safe and effective medical abortions,” says Attaie.

If you or someone you know needs help obtaining an abortion or additional information and resources, visit abortionfunds.org or abortionfinder.org. You can also call or text All options Hotline at 1-888-493-0092, which provides “unconditional, non-judgmental support for people with all their decisions, feelings and experiences about pregnancy, parenthood, abortion and adoption.”

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