As concerns grow over restricted access to mifepristone, many 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. 

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 works first by blocking the body’s natural production of progesterone, a hormone that allows a pregnancy to grow. Without progesterone, the pregnancy doesn’t continue.   

Then, 24 to 48 hours later, misoprostol is taken to soften the cervix and cause heavy bleeding, cramping, and contractions to expel the pregnancy from the uterus. 

How does a misoprostol–only abortion work? 

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 much 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. This can be emotionally overwhelming to go through this process alone if you don’t have someone there you trust to support you. 

How effective is misoprostol alone for medication abortion?  

What happens when misoprostol is taken 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.  

Because misoprostol doesn’t end the pregnancy first, there is also a risk that the fetus could still be alive when expelled. Studies show a 17% survival rate during a misoprostol-only abortion.  

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. 

Are there other risks or 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. 

What Should I Know First?

Before taking misoprostol, or any form of abortion pill, 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 a nonviable pregnancy 

Taking misoprostol without ruling out a non-viable pregnancy can mask the symptoms like 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 determine the safest way to treat this type of pregnancy complication. Ectopic pregnancies can be life threatening and need immediate care and treatment by a licensed physician for the best outcome and future reproductive health of the woman.

 3. If you have a condition which makes misoprostol dangerous 

People with kidney disease, stomach ulcers, inflammatory bowel disease, heart or blood vessel problems, uncontrolled asthma, or dehydration should not take misoprostol, as it can worsen these conditions. 

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 is crucial before taking misoprostol or mifepristone. Empower SAV™ offers pre-abortion screenings with no insurance required.