The recent order from the United States Supreme Court on the distribution of mifepristone, the first drug in a medication abortion (also known as Mifeprex), has caused significant controversy and discussion about the drug’s safety and legality. While the ruling allows the continued distribution of the drug according to current FDA regulations, that does not mean the case is over. The Supreme Court has sent the issue back to lower courts, meaning it may have to rule directly on the case’s merits in the future.
With rumors of the FDA approval of mifepristone potentially being revoked, many women have questions about the legality of abortion pills and the safety and possibility of a misoprostol-only abortion. Some online abortion pill providers have pulled mifepristone from their sites, and women can no longer get abortion pills by mail.
(Note: This is an active, ongoing court case. Information last updated May 2023.)
What does Mifepristone do?
Mifepristone, the first drug in the abortion pill regimen, works by blocking the hormone progesterone, which is needed for a pregnancy to continue. The drug causes the lining of the uterus to break down and cuts off nutrients the developing fetus needs to live.
What does Misoprostol do?
Misoprostol is typically the second drug in a medication abortion and is taken within 24 hours of Mifepristone. Misoprostol works by causing the uterus to contract, leading to the expulsion of the pregnancy.
Is a Misoprostol-only abortion a safe alternative?
While Misoprostol can be used alone to induce an abortion, it is less effective than using both Mifepristone and Misoprostol in combination. Using Misoprostol alone can also lead to increased pain and bleeding and a higher risk of incomplete abortion. The medical community does not broadly recommend a misoprostol-only abortion due to the increased side effects and pain. Side effects of a misoprostol-only abortion are:
increased cramping and stomach pain
nausea and/or vomiting
gas
heavy bleeding
inability to urinate
heavy sweating
hot and dry skin and feeling very thirsty
severe ongoing stomach discomfort or diarrhea
painful menstruation and heavy menstrual flow
What do I need to know before I decide?
Not all women are eligible for the abortion pill or may have allergic reactions to misoprostol. Talk to a health professional if you have a history of dehydration, heart or blood vessel problems, inflammatory bowel disease, ulcers, or kidney disease; you should not take misoprostol. You may also have questions like, what is the best route of administration of misoprostol for abortion? Is misoprostol legal in my state? Is it safe to order online? What is the price of misoprostol-only abortions? How do I know if it’s complete?
If you are considering a medical abortion, it is wise and in the best interest of your health and well-being to first confirm the placement and viability of your pregnancy by having an ultrasound. The ultrasound will help you gather the necessary information to help you make an informed decision by determining the location of the pregnancy, ruling out an ectopic pregnancy, as well as determining how far along you are and if your pregnancy is viable.
It is crucial for your overall health and well-being to speak with a healthcare provider to understand the potential short and long-term risks of any abortion method, signs of incomplete abortion after misoprostol, and get answers to your questions before you make a decision.
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References
Pain during medical abortion, the impact of the regimen: a neglected issue? A review. Fiala C, Cameron S, Bombas T, Parachini M, Saya L, Gemzell-Danielsson K. Eur J Contracept Reproductive Health Care. 2014 Dec;19(6):404-19. doi: 10.3109/13625187.2014.950730. Epub 2014 Sep 2. PMID: 25180961
Supreme Court Puts on Hold Ruling That Restricts Access to Abortion Pill Mifepristone. (2023, April 16). www.theepochtimes.com. https://www.theepochtimes.com/supreme-court-puts-on-hold-ruling-that-restricts-access-to-abortion-pill-mifepristone_5195774.html
Bourne, L. (2023). Breaking: Supreme Court extends stay permitting access to abortion pill, deadline set for Friday. Pregnancy Help News. pregnancyhelpnews.com/breaking-supreme-court-extends-stay-permitting-access-to-abortion-pill-deadline-set-for-friday
Misoprostol (Oral Route) Side Effects – Mayo Clinic. (n.d.).