As concerns grow over restricted access to mifepristone, many women are turning their attention to medical abortions being performed with only misoprostol.

While this option may appear simpler, cheaper, or more private, there’s a lot you need to know beforehand, like how a misoprostol-only abortion works and the risks it carries.

Please note: this article is for informational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Always consult a healthcare professional for medical concerns or emergencies.

Can you take misoprostol without mifepristone?

How does the normal abortion pill process work?

Normally, a medication abortion (the abortion pill) involves two drugs: mifepristone and misoprostol.

Mifepristone blocks the effects of progesterone,, a hormone needed to support pregnancy, in the uterus. Without progesterone being able to do its job, the pregnancy can no longer continue. 

Then, 24 to 48 hours later, misoprostol is taken to soften and open the cervix. It causes the uterus to contract and expel the pregnancy.

What is a misoprostol-only abortion?

When misoprostol is taken without mifepristone, the first step of ending the pregnancy is skipped.

To compensate, multiple doses of misoprostol are taken in an attempt to force the body to expel the pregnancy, but this approach is less predictable and less effective than using both mifepristone and misoprostol together.

Women considering a misoprostol-only abortion should also understand that since the pregnancy has not been stopped, it’s possible to see the living fetus when it is expelled, especially if they are later in pregnancy. For many, this can be an unexpected and deeply distressing experience. It’s a good idea to have someone you trust with you for support, as it can be emotionally overwhelming to go through this process alone.

Are misoprostol-only abortions effective?

What to expect when taking misoprostol without mifepristone?

Beyond its lower effectiveness, the experience itself can be physically and emotionally difficult. Many women aren’t fully prepared for what happens during the process, especially the possibility of seeing recognizable tissue or even the developing fetus, depending on how far along the pregnancy is.

If abortion medication does not work as expected, the pregnancy may continue. Because of this, follow-up with a medical provider is important.

If the abortion is incomplete and the pregnancy continues, misoprostol exposure can also lead to birth defects, putting the child at risk for serious health complications.

What are the risks and complications?

Many women choose medical abortion because it seems like a more private, less invasive option than a surgical abortion. However, medical abortions have been linked to more complications and risks.

Common/Expected Side Effects:

• Cramping
• Bleeding
• Nausea, vomiting, diarrhea
• Fever or chills
• Dizziness or headache

Serious risks:

• Heavy or prolonged bleeding
• Infection
• Incomplete abortion or retained tissue
• Ongoing pregnancy
• Rare allergic reaction
• Rare uterine rupture, especially later in pregnancy or with prior uterine surgery/C-section

I can’t keep this pregnancy. What should I do first?

Before taking misoprostol, you should know the following answers about your health.

1. How far along you are

Taking the abortion pill past 10 weeks increases your risk of an incomplete abortion and complications.

2. Whether you have an ectopic pregnancy (outside the uterus)

Taking misoprostol without ruling out a non-viable pregnancy can mask the symptoms of a life-threatening ectopic pregnancy.

An ectopic pregnancy cannot be treated or ended with any type of abortion pill, whether it’s mifepristone, misoprostol, or a combination of both. They must be treated by a doctor who can decipher the safest way to remove it.

3. If you have a condition which makes misoprostol dangerous

Some health conditions may make abortion medication riskier. Before taking misoprostol, a woman should talk with a medical professional if she has heart disease, kidney disease, inflammatory bowel disease, severe diarrhea, dehydration, a history of uterine surgery or C-section, or an allergy to misoprostol or prostaglandins.

4. What to expect and look out for with this drug

Understanding what’s normal and when to seek medical help can make a crucial difference in your health and safety. 

A medical consultation and ultrasound with a licensed medical professional are crucial before taking misoprostol. Parkville Women’s Clinic offers free pregnancy consultations.